CTICasesEmpyema following Chest Trauma
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Imaging findings
Frontal and lateral radiographs showed a very large, non-effacing opacity in the left hemithorax, consistent with a posterior pleural space process. The lateral projection showed a large lenticular shape of an intrapleural fluid collection with gas/air within it. CT confirmed a large pleural fluid collection with air, consistent with empyema. A couple of rib fractures were noted from a fall weeks prior.
Key takeaways
Empyema, especially after chest trauma, can present as a large, lenticular, intrapleural fluid collection with air. Radiographic signs like non-effacement of vessels on frontal view and a lenticular shape on lateral view are key to distinguishing it from intraparenchymal lesions. Elderly patients, sometimes with impaired immunity, can develop extensive empyema with minimal symptoms.
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