Case Study Of Littleton Hospital
This case study examines the findings for a patient admitted to Littleton Hospital in February 2016. This patient was initially radiographed on February 8th and again on February10th, 2016, when the radiology department received orders for a portable chest x-ray for an 82-year-old patient in the ICU. Two days prior, she had received a chest x-ray, post-thoracentesis. At that time, the radiologist, Dr. Orlin Hopper noted “a moderate right-sided pneumothorax” (2016). Upon review of the second set of images, the radiologist noted, “the right lung appeared unchanged with pleural thickening and air in the right pleural space, much of which was loculated” (Hopper, 2016). Dr. Hopper also noted a possible trapped lung.
In subsequent documentation for
the initial visit, the Dr. Hopper, diagnosed a significant pneumothorax. The patient received a chest tube and exhibited brief moderate resolution of the pneumothorax lasting less than 48 hours. Final images prior to release, demonstrated that the patient’s pleural effusion had returned, masking any evidence of a trapped lung. The patient was readmitted less than two weeks later, stabilized and released to a skilled nursing facility with the goal of transitioning to an assisted living facility. The discharging physician at that time, Leslie A Schipper, DO, noted in her assessment “an unchanged atelectasis with cardiomegaly and large right pleural effusion, showing near-complete opacification of the right hemithorax, consistent with past history” (p.1, 2016). Dr. Schipper’s discharge diagnoses further state, “chronic right pleural effusion with trapped lung” (p. 1, 2016). Dr. Schipper’s discharge notes are the last records for this patient. There have been no further images and no further information is available to indicate final outcome.
According to Dr. Jennifer Hankinson, a radiologist at Littleton Hospital, a trapped lung often occurs in patients that have recurrent pneumothoraces (2017). Even after air and fluid has been removed, a trapped lung fails to re-inflate without medical intervention (Hankinson, 2017). As the
In subsequent documentation for
the initial visit, the Dr. Hopper, diagnosed a significant pneumothorax. The patient received a chest tube and exhibited brief moderate resolution of the pneumothorax lasting less than 48 hours. Final images prior to release, demonstrated that the patient’s pleural effusion had returned, masking any evidence of a trapped lung. The patient was readmitted less than two weeks later, stabilized and released to a skilled nursing facility with the goal of transitioning to an assisted living facility. The discharging physician at that time, Leslie A Schipper, DO, noted in her assessment “an unchanged atelectasis with cardiomegaly and large right pleural effusion, showing near-complete opacification of the right hemithorax, consistent with past history” (p.1, 2016). Dr. Schipper’s discharge diagnoses further state, “chronic right pleural effusion with trapped lung” (p. 1, 2016). Dr. Schipper’s discharge notes are the last records for this patient. There have been no further images and no further information is available to indicate final outcome.
According to Dr. Jennifer Hankinson, a radiologist at Littleton Hospital, a trapped lung often occurs in patients that have recurrent pneumothoraces (2017). Even after air and fluid has been removed, a trapped lung fails to re-inflate without medical intervention (Hankinson, 2017). As the