Chapter 7: Pleural Cavity

Introduction

The thorax is an enormous source of pathology and related imaging. It has been divided into the pleural cavity and mediastinum because of this.

The pleural cavity includes the chest walls, diaphragm, pleural space, lower airways (below the larynx) and the lungs.

It is difficult to group many of these conditions, but they fit reasonably well into the selected categories.

Normal Images

Chest Walls

Notes

History of compression injury to chest, acute severe chest pain at rib angles, dyspnea.

Report

Complete right pneumothorax with minimal mediastinal shift. Fractured ribs at their angles (arrowed).

Treatment

Intercostal catheterization.

Notes

Acute chest injury with rapidly progressive chest pain, dyspnea, and cyanosis.

Report

Large left pneumothorax with complete lung collapse and right mediastinal shift. A tension pneumothorax.

Treatment

Puncture 2nd intercostal space (midclavicular line) then intercostal catheterization.

Notes

Dyspnea and cyanosis at birth. Bowel sounds heard in left side of chest.

Report

Numerous gas-filled loops of gut in left hemithorax. Mediastinal shift to right. Lack of gut loops in abdomen. Diaphragmatic hernia (congenital).

Treatment

Diaphragmatic repair.

Notes

Dyspnea following major abdominal trauma.

Report

Opacification of left hemithorax with intrathoracic gastric air bubble (ruptured diaphragm).

Treatment

Diaphragmatic repair.