Possible Causes for mediastinal shift Pleuropulmonary Blastoma shift, frequent pleural effusion, and no chest wall invasion. [ncbi.nlm.nih.gov] In contrast to adults, children that undergo this intervention are prone to postoperative mediastinal shift, which leads to bronchial stretching resulting in severe respiratory [ncbi.nlm.nih.gov] Unilateral lung whiteout on plain film with mediastinal shift to opposite side. Usually there are no adjacent rib erosions or calcifications. [deeprad.de] Obstructive Atelectasis shift ipsilateral tracheal deviation ipsilateral shift of the heart [radiopaedia.org] Repeat chest radiograph revealed white out of the right hemi-thorax with tracheal and mediastinal shift to right [Figure 2] a. [indianjcancer.com] Chest X-ray revealed atelectasis of the right upper lobe (RUL) with ipsilateral mediastinal shift ( Fig. 1 ). X-ray on admission was normal. [archbronconeumol.org] Diaphragmatic Eventration A mediastinal shift to the contralateral side may cause significant compression of the affected chest contents, resulting in compromised pulmonary function, especially when [ncbi.nlm.nih.gov] In adults, mostly it is asymptomatic, usually it involves left hemidiaphragm with right sided mediastinal shift [ 1 ]. [omicsonline.org] His chest radiograph showed a raised left diaphragmatic dome with a gastric shadow obliterating the left lung field and mediastinal shift to the right [Figure 1]. [archintsurg.org] Scimitar Syndrome Mediastinal shift to the right with dextroversion of the heart. [slideshare.net] Chest radiography showed volume loss of the right lung with mediastinal shift to the right and opacification of the right hemithorax. [sajr.org.za] Plain radiograph Chest radiographic findings are that of a small lung with ipsilateral mediastinal shift, and in one-third of cases, the anomalous draining vein may be seen [radiopaedia.org] Foreign Body Aspiration CONCLUSION: Penetration syndrome, localized decreased breath sounds, unilateral hyperinflation and/or mediastinal shift on radiology are predictors for early diagnosis of [ncbi.nlm.nih.gov] Tracheal deviation, mediastinal shift. Diagnostic workout: Anamnesis (extraordinary episode of coughing, peanuts ?). [kidsdoc.at] Chest x-ray showed overdistension of the left lung and a mediastinal shift. Foreign body aspiration was diagnosed. [ncbi.nlm.nih.gov] Hydropneumothorax Computed tomography of the thorax showed multiple bilateral cavitating lesions and a right-sided hydropneumothorax with mediastinal shift. [ncbi.nlm.nih.gov] A chest x-ray revealed mediastinal shift and a left sided pneumothorax. Drainage was carried out, revealing air and clear fluid in the pleural space. [ncbi.nlm.nih.gov] Diaphragmatic Hernia At autopsy, the left pleural cavity was occupied by herniated abdominal contents with mediastinal shift. [ncbi.nlm.nih.gov] Air entry was reduced on the left side chest with mediastinal shift to the right. Abdominal examination was normal. [emj.bmj.com] shift to the right compression of the contralateral lung In doubtful cases, a naso-gastric tube is inserted and a chest radiograph is taken: the feeding tube will be seen [amboss.com] Artificial Pneumothorax Abstract Systemic air embolism occurred in a patient during general anaesthesia, with positive pressure ventilation, following induction of artificial pneumothorax to assist in the diagnosis of a mediastinal mass. A sudden change in vital signs together with neurological abnormalities suggested involvement of both[…] [ncbi.nlm.nih.gov] Malignant Pleural Effusion A patient presented to the emergency department with a malignant pleural effusion associated with shortness of breath, and radiographic evidence of mediastinal shift and hypotension [ncbi.nlm.nih.gov] Chest radiograph reveals right upper lobe collapse and a moderate sized right-sided pleural effusion with no mediastinal shift. [clevelandclinicmeded.com] Such a situation may be suggested by lack of mediastinal shift on perioperative radiographs or may be seen only at surgery. [doi.org] Pulmonary Blastoma shift. [ncbi.nlm.nih.gov] Unilateral lung whiteout on plain film with mediastinal shift to the opposite side. Usually, there are no adjacent rib erosions or calcifications. [radiopaedia.org] Pleuropulmonary blastomas often present late radiographically as a unilateral lung whiteout on plain film with mediastinal shift to the opposite side. [radiopaedia.org] Pleural Effusion A 13-year-old boy with no risk factors for lung cancer presented with a massive left-sided pleural effusion and a mediastinal shift on chest radiography and computed tomography [ncbi.nlm.nih.gov] A very large pleural effusion appears as an opaque hemithorax with a mediastinal shift to the contralateral side. [radiopaedia.org] shift 3000mL opacification of hemithorax contralateral mediastinal shift PLEURAL FLUID Things to put on the lab form: Protein LDH Glucose pH WCC Cytology Amylase HCT Gram [lifeinthefastlane.com] Atelectasis After 2 days ceftriaxone sodium administration, her chest radiograph revealed a rightward mediastinal shift caused by atelectasis of the upper portion of the right lung. [ncbi.nlm.nih.gov] shift Compensatory overinflation Approximation of ribs Signs of AtelectasisElevation of Hemidiaphragm Much more likely in lower lobe atelectasis Signs of AtelectasisMediastinal [learningradiology.com] This effect can lead to an elevated diaphragm and mediastinal shift to the affected side. Treatment depends on the underlying cause. [amboss.com] Congenital Malformation of the Lung Location and size of the lesion, presence of mediastinal shifting and associated malformations were noted. [journals.plos.org] Mediastinal shift may be present, with hyperresonance and decreased breath sounds on the involved side. [emedicine.medscape.com] shift may compromise cardiac and respiratory function Spontaneous pneumothoraces (collapsed lungs) may occur, and air trapping within the cyst, which leads to compression [childrensnational.org] Compression Atelectasis Mediastinal Shift Usually greatest in area of greatest loss of volume Upper lobe, shift of upper trachea Signs of Atelectasis Compensatory Overinflation With larger [learningradiology.com] Often seen in pts with ARDS Signs and symptoms that indicate tension PTX Severe dyspnea and tachycardia Tracheal and mediastinal shift Systemic hypotension due to decreased [quizlet.com] Some indirect signs of volume loss include vascular crowding or fissural, tracheal, or mediastinal shift, towards the collapse. [med-ed.virginia.edu] Traumatic Pneumothorax Complete collapse of affected lung with increased pressure in chest resulting in mediastinal shift and impaired venous return to heart. [quizlet.com] The mediastinal shift that was caused by the tension pneumothorax (Fig. 5 in the Supplementary Appendix ) caused mild circulatory instability (blood pressure, 80/40 mm Hg; [nejm.org] In a tension pneumothorax, findings may include a displaced point of maximal impulse, tracheal deviation, mediastinal shift, and hemodynamic instability. [journals.lww.com] Dextrocardia BACKGROUND/OBJECTIVES: Dextrocardia is rare in the general population, and may be associated with significant additional cardiac malformations. We aimed to identify the prevalence and patterns of additional cardiac defects, as well as the associated long-term morbidity and mortality, in adult patients with[…] [ncbi.nlm.nih.gov] Mediastinal Hernia If deflation of the stomach is not accomplished the mediastinal shift can impair venous return and lead to cardiac arrest [ 3, 12 – 14 ]. [sjtrem.biomedcentral.com] Left mediastinal shift with right congenital diaphragmatic hernia is rare and life threatening malformation. [pulsus.com] Because, like our patient, in the elderly gastrointestinal obstruction and acute distention of herniated viscera and mediastinal shift are less tolerable. [firattipdergisi.com] Congenital Diaphragmatic Hernia shift to the left. [ncbi.nlm.nih.gov] X-ray documented distended loops of bowel with air fluid levels in the abdomen and a gasless, non-homogeneous opacity of the left hemithorax, a right mediastinal shift and [ncbi.nlm.nih.gov] shift to the right. [ncbi.nlm.nih.gov] Congenital Lung Cyst Imaging: Chest x-ray as initial investigation to evaluate airway impingement and mediastinal shift and infection. [clinicalpainadvisor.com] Hydrops is secondary to vena caval obstruction and cardiac compression from large tumors causing an extreme mediastinal shift. [chop.edu] CONGENITAL CYSTIC ADENOMATOID MALFORMATION• The entire malformation may cause a mediastinal shift to the opposite side and compressive atelectasis of otherwise normal adjacent [slideshare.net] Diaphragmatic Rupture His chest radiography and computed tomography demonstrated left diaphragmatic rupture, mediastinal shift and herniation of gastric fundus into the pleural cavity. [ncbi.nlm.nih.gov] Axial computed tomography scan shows mild mediastinal shift to the right and a positive dependent viscera sign. [rc.rcjournal.com] shift visualization of a nasogastric tube above the hemidiaphragm on the left side left hemidiaphragm much higher than the right CT Direct discontinuity of the hemidiaphragm [radiopaedia.org] Congenital Pulmonary Hypoplasia A chest roentgenogram showed homogeneous opacity occupying the entire right up hemithorax, hyperinflated left lung, and mediastinal shift to the right (Figure 2(a)). [hindawi.com] Also note the mediastinal shift and corresponding atelectasis of the right lung. Figure 18. [clinicaladvisor.com] Plain radiography shows absence of aeration of the affected lung, with ipsilateral mediastinal shift. [jbsr.be] Iatrogenic Pneumothorax If not relieved, it can lead to lung collapse and mediastinal shift. [medical-dictionary.thefreedictionary.com] Potential complications include tension pneumothorax, the accumulation of air in the pleural space causing mediastinal shift and circulatory collapse. [journals.lww.com] Tracheal deviation (the trachea is skewed away from the side of the tension pneumothorax) signifies that a mediastinal shift has occurred and is an ominous sign. [teleflex.com] Tracheal Foreign Body On an expiratory film there is air trapping on the affected side and mediastinal shift to the unaffected side. [virtualpediatrichospital.org] There may be lung collapse with severe mediastinal shift or obstructive emphysema. [jpma.org.pk] Showing evidence of hyper-inflated right lung, left lower lobe atelectasis, mediastinal shift and a clear radio-opaque foreign body in the left main (arrowed) bronchus. [southsudanmedicaljournal.com] Congenital Emphysema Post-operative chest X-ray showed expansion of the right upper and lower lobes, with no emphysema or mediastinal shift. [jcnonweb.com] The ipsilateral rib spaces may be widened, the ipsilateral hemidiaphragm may be depressed, and there may be contralateral mediastinal shift. [roentgenrayreader.blogspot.com] The cardiac apex may be displaced if marked mediastinal shift is present. [prognosisapp.com] Bronchial Compression None of our cases demonstrated the more usual signs of hyperinflation which are a hyperlucent lung field, depressed hemidiaphragm and mediastinal shift away from the affected [ncbi.nlm.nih.gov] These events were the result of compression of the left main bronchus against the vertebral column by the mediastinal contents, which had shifted into the right hemithorax [ncbi.nlm.nih.gov] shift rather than focal hyperinflation tubular structure paralleling the right heart border in the shape of a Turkish sword (“scimitar”) endobronchial tumor (e.g. carcinoid [radiopaedia.org] Hemopneumothorax Serial chest x-rays were obtained to document mediastinal shift before and after treatment. Arterial blood gas values and physiologic data were recorded. [ncbi.nlm.nih.gov] The left lung is collapsed, therefore the accumulation of fluid and air in the left pleural space does not result in mediastinal shift. [pedsradiology.com] Mediastinal shift to left. 1 case question available Case Discussion The Heimlich valve is a small one-way valve used for chest drainage of air and or fluid. [radiopaedia.org] Congenital Unilateral Pulmonary Hypoplasia Chest X-ray showing hypoplasia of the right lung with mediastinal shift to the right. [slideshare.net] In these cases, a fluid-filled structure causing mediastinal shift may be present within the chest. [sonoworld.com] A leftward mediastinal shift was seen (Figure 1). Citation: Sagie G, Koplewitz BZ, Sagui G, Cohen S, Springer C, et al. [austinpublishinggroup.com] Pneumothorax Large pneumothorax with mediastinal shift 17. Large pneumothorax with mediastinal shift 18. Tension Pneumothorax 19. Tension pneumothorax 20. Tension pneumothorax 21. [slideshare.net] In a tension pneumothorax, findings may include a displaced point of maximal impulse, tracheal deviation, mediastinal shift, and hemodynamic instability. [journals.lww.com] Check for mediastinal shift (which would indicate the presence of a tension pneumothorax). [almostadoctor.co.uk] Bronchopulmonary Sequestration This lesion caused compression of the normal left lung tissue and contralateral mediastinal shift. [ncbi.nlm.nih.gov] The prognosis is poor in cases diagnosed before 26 weeks' gestation and when there is mediastinal shift, polyhydramnios and fetal hydrops. [ncbi.nlm.nih.gov] All had significant mediastinal shift and polyhydramnios, but normal doppler flow parameters. [thieme-connect.com] Foreign Body in the Bronchus There may be lung collapse with severe mediastinal shift or obstructive emphysema. [jpma.org.pk] X- ray chest revealed partial collapse of right lung with mediastinal shift and hyperinflation of left lung. [ispub.com] shift Pneumomediastinum Confirmatory imaging studies If the patient is clinically able, an expiratory chest radiograph may demonstrate air-trapping on the affected side by [learningradiology.com]
