Mediastinal Shift: Causes & Reasons

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Possible Causes for Mediastinal Shift

Obstructive Atelectasis

shift ipsilateral tracheal deviation ipsilateral shift of the heart [radiopaedia.org]

[…] structures shift toward side of atelectasis shift toward side of atelectasis Obstructive Atelectasis: Mediastinal structures _______________ Diaphragm elevates on affected [quizlet.com]

shift") potential causes of resorptive atelectasis include obstructing neoplasms, mucous plugging in asthmatics or critically ill patients and foreign body aspiration resorptive [radiopaedia.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]

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]

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]

Lobectomy or Pneumonectomy

CT The lung is absent at the side of surgery, with resultant mediastinal shift and compensatory hyperinflation of the contralateral lung. Promoted articles (advertising) [radiopaedia.org]

A fistula between the bronchus and pleura sometimes occurs, leading to subcutaneous emphysema and mediastinal shift caused by a massive air leak. [medical-dictionary.thefreedictionary.com]

Second point, there may be no sign to suggest mediastinal shift in lobectomy ( central trachea) but in penumonectomy, you are expected to find signs suggesting mediastinal [passpaces.com]

Tension Pneumothorax

He was clinically stable without hypoxia or hypotension, and the initial chest x-ray study showed a large pneumothorax without mediastinal shift. [ncbi.nlm.nih.gov]

If not relieved, it can lead to lung collapse and mediastinal shift. [medical-dictionary.thefreedictionary.com]

Giant bulla may mimic TPX with wide radiolucent view and mediastinal shift. The present report includes giant pulmonary bulla in 35-year-old woman. [ncbi.nlm.nih.gov]

Bronchial Obstruction

Computed tomography revealed a large endobronchial lesion causing occlusion of the left main bronchus and significant mediastinal shift to the left. [ncbi.nlm.nih.gov]

Conclusion: Obstruction of the right main bronchus by a soft tissue mass resulting in airless "drowned" right lung with subsequent volume loss and mediastinal shift. [radiopaedia.org]

Chest radiography reveals left-sided volume loss with mediastinal shift and multifocal heterogeneous opacities within the mid-lower left lung field. [clevelandclinicmeded.com]

Pleuropulmonary Blastoma

shift, frequent pleural effusion, and no chest wall invasion. [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]

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]

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]

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]

Hydropneumothorax

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]

Computed tomography of the thorax showed multiple bilateral cavitating lesions and a right-sided hydropneumothorax with mediastinal shift. [ncbi.nlm.nih.gov]

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]

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]

Iatrogenic Pneumothorax

If not relieved, it can lead to lung collapse and mediastinal shift. [medical-dictionary.thefreedictionary.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]

Potential complications include tension pneumothorax, the accumulation of air in the pleural space causing mediastinal shift and circulatory collapse. [journals.lww.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]

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]

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]

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]

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]

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]

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]

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]

Air entry was reduced on the left side chest with mediastinal shift to the right. Abdominal examination was normal. [emj.bmj.com]

Swyer-James Syndrome

Radiological findings are characteristic and include a pronounced one sided hyperlucency of the lung (due to oligemia), a mediastinal shift toward the affected side on inspiration [ncbi.nlm.nih.gov]

Other features on this modality include hypovascularity, a mediastinal shift towards the affected lung, a small hilar shadow, and air trapping with expiration. [symptoma.com]

shift toward the hyperlucent thorax Ventilation-Perfusion (V/Q) Scan Decreased perfusion on affected side Retention of inhaled radionuclide on affected side MDCT (Fig. [vcuthoracicimaging.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]

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]

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]

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]

Bronchopleural Fistula

On examination, a mediastinal shift is noted. [symptoma.com]

Postpneumonectomy syndrome is a rare complication of pneumonectomy characterized by mediastinal shift toward the pneumonectomy cavity. [ncbi.nlm.nih.gov]

A fistula may cause air leakage leading to spontaneous pneumothorax, collapse of the lung or mediastinal shift. [academic.oup.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]

Congenital Pulmonary Hypoplasia

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]

Chest X-ray showing hypoplasia of the right lung with mediastinal shift to the right. [slideshare.net]

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]

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]

In 4 babies chest X-ray showed tracheal and mediastinal shift to the opposite side. Increased translucency was noted on the affected side [Figure - 1]. [jpgmonline.com]