Medical image of the week: a positive sniff test

Southwest Journal of Pulmonary and Critical Care

Sam A¹  Young R¹  Huthayfa A¹ 

[1] University of Arizona, Tucson, AZ USA;

关键词: sniff;    test;    treatment;    CT scan;    flouroscopy;    paralyzed;    hemidiaphragm;    diabetes;    neuropathy;    paradoxical movement;   

DOI  :  10.13175/swjpcc050-17

来源: DOAJ

【 摘 要 】

No abstract available. Article truncated at 150 words. A 66-year-old man with a history of hypertension, morbid obesity, emphysema, type 2 diabetes complicated by extensive peripheral neuropathy presented for evaluation of persistent fatigue, shortness of breath and increased oxygen requirements. Approximately 18 months prior to presentation the patient required intubation for septic shock with multifocal pneumonia and right lower lobe collapse. The patient left the hospital after 10 days on 4 liters of oxygen and had been oxygen dependent since then with no improvement despite aggressive pulmonary rehabilitation. A pulmonary function test (PFT) demonstrated a moderate, restrictive ventilatory defect with low diffusion capacity; while his thoracic computed tomography showed persistent elevation of the right hemi-diaphragm with right lower lobe and partial middle lobe atelectasis (Figure 1). No evidence of endobronchial lesions, mediastinal or cervical masses, or enlarged lymph nodes seen. The patient underwent a fluoroscopic sniff test that confirmed paralysis of the right hemi-diaphragm (Figure 2) (1). Phrenic …

【 授权许可】

Unknown