The failed thoracocentesis.
How often do we consider a differential diagnosis of diaphragmatic hernia in cases of failed thoracocentesis? How many of us remember that omental fat in the chest can behave in a fluid manner, layering along the chest wall, resulting in the misinterpretation of a decubitus view. A case is presented of a diaphragmatic hernia that was missed on conventional chest radiographs resulting in CT having to be performed. A high degree of suspicion is mandatory to reach the final diagnosis. Radiographs could be used more effectively and CT avoided.
D000328:Adult; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006548:Hernia, Diaphragmatic / Q000000981:diagnostic imaging*; D006801:Humans; D009852:Omentum / Q000000981:diagnostic imaging; D010996:Pleural Effusion / Q000000981:diagnostic imaging; D013907:Thoracostomy; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure
D003287:Contrast Media