Mediastinal position and air-fluid height after pneumonectomy: the effect of the respiratory cycle.
After pneumonectomy, a shift of the mediastinum toward the nonoperated side may be the initial indicator of a postoperative problem such as empyema, bronchopleural fistula, esophageal-pleural fistula, hemothorax, or recurrent tumor. Postoperatively, a drop in the fluid level on the operated side may indicate a bronchopleural fistula or other fistulous connection. To assess the effect of the respiratory cycle on these two signs, 16 patients were studied with inspiration-expiration films. In every case the mediastinum shifted toward the normal side in expiration, and in no case did a fluid level change position by more than 5 mm with respiratory maneuvers. Therefore, the respiratory phase must be considered when assessing the significance of mediastinal shift after pneumonectomy.
D000328:Adult; D000368:Aged; D001982:Bronchial Diseases / Q000000981:diagnostic imaging; D004653:Empyema / Q000000981:diagnostic imaging; D005260:Female; D005402:Fistula / Q000000981:diagnostic imaging; D006491:Hemothorax / Q000000981:diagnostic imaging; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008482:Mediastinum / Q000000981:diagnostic imaging*; D008875:Middle Aged; D010995:Pleural Diseases / Q000000981:diagnostic imaging; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011859:Radiography; D012119:Respiration; D013997:Time Factors