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Indian Journal of Critical Care Medicine
Medknow Publications on behalf of the Indian Society of Critical Care Medicine
ISSN: 0972-5229 EISSN: 1998-359x
Vol. 15, Num. 2, 2011, pp. 142-143

Indian Journal of Critical Care Medicine, Vol. 15, No. 2, April-June, 2011, pp. 142-143

Letter to the Editor

Authors' reply

Jyotindu Debnath1, Rajesh Kumar2, R Bala Murali Krishna3, Ankit Mathur1

1 Department of Radiodiagnosis, 167 Military Hospital, Pathankot, India
2 Department of Surgery, 167 Military Hospital, Pathankot, India
3 Department of Anesthesiology, 167 Military Hospital, Pathankot, India

Correspondence Address: Jyotindu Debnath Department of Radiodiagnosis and Imaging, 167 Military Hospital, Pathankot India jyotindu_debnath@rediffmail.com

Code Number: cm11038

Sir

At the outset, we thank the concerned reader [1] for showing keen interest in our article. [2] The issues raised by the interested reader are relevant. Pitfalls of portable chest radiographs in emergency setting are well known. There can be apparent mediastinal shift due to improper patient positioning. However, it is not difficult to diagnose such a condition on a chest radiograph by a radiologist. Moreover, it is hard to overlook patient positioning-related apparent mediastinal shift in a chest computed tomography (CT) scan, particularly in a multidetector CT (MDCT) as in our case. Also, one can confidently differentiate hyperinflation from oligemia leading to increased transradiance of affected pulmonary parenchyma in an MDCT. Features of hyperinflation of left lung are obvious in the given images [Figure - 1] and [Figure - 2]. If hypoventilation-mediated vasoconstriction and oligemia alone was responsible for the increased transradiance of the left lung parenchyma, some amount of ipsilateral mediastinal shift (due to varying degree of absorption of alveolar air) would have been observed rather than contralateral mediastinal shift.

References

1.Panigrahi MK. Contralateral hyperinflation: computed tomography demonstration of an unusual complication of unrecognized endobronchial intubation. Indian J Crit Care Med 2011;15:142.  Back to cited text no. 1    
2.Debnath J, Kumar R, Krishna RB, Mathur A. Contralateral hyperinflation: Computed tomography demonstration of an unusual complication of unrecognized endobronchial intubation. Indian J Crit Care Med 2011;15:52-4.  Back to cited text no. 2  [PUBMED]  

Copyright 2011 - Indian Journal of Critical Care Medicine

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[cm11038f2.jpg] [cm11038f1.jpg]
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