Caceres’s Corner Case 68 (Update: Solution)


Dear Friends,

Summer is near and Muppet wants to relax and show easy cases. The present one relates to an 80-year-old male with RUQ pain after embolisation of a liver tumour.


1. Pulmonary embolism
2. Pneumonia
3. Subpulmonary fluid
4. None of the above

80-year-old male, PA chest

80-year-old male, PA chest

80-year-old male, lateral chest

80-year-old male, lateral chest

Leave your thoughts and diagnosis below and look out for the answer next Tuesday.

Click here for the answer to case #68

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    May 2013
    DISCUSSION 9 Comments

    9 Responses to : Caceres’s Corner Case 68 (Update: Solution)

    1. Dr. os says:

      PA and lateral chest radiography shows:

      A right side diaphragmatic hump is seen which has smooth well defined outline with an obtuse angle as well as its peripheral location,consistent with extra-pulmonary location;
      In view of patient history of embolisation of liver tumour, I think the finding is due to post embolisation sequelae, likely hepatic haematoma.
      US and CT abdomen with contrast are recommended .

    2. D Strangelove says:

      Emphysematous cholecystitis.
      Subphrenic abscess.

    3. Katerina says:

      Elevation of the anterior-medial portion of the right hemidiaphragm (may be due to eventration, which is common in elderly persons). No lateral peaking of the dome (subpulmonary effusion is ruled off).
      Downward shifting of the right hilum, the minor fissure and backward shifting of the right major fissure (reduced volume of RLL – atelectasis).
      Pulmonary infiltrates in the RLL and LLL
      Air in the biliary tree and may be around the gallbladder (emphysematous cholecystitis due to embolisation?)

    4. Bruno says:

      subfrenic collection (abscess) with elevation of the right hemidiaphragm.

    5. gus says:

      Right diaphragmatic elevation (sub diaphragmatic compress)with atelectasis of the RLL maybe from the liver tumor (not from ascites)or normal diaphragmatic hump.
      small effusion in both costophrenic angles or pleural thickening.
      pulmonary infiltrates in LLobes (we must to think for metastasis)
      air in the wall of gallbladder or in tumor post embolization?

    6. genchi bari italia says:

      Una delle complicanze della TACE è la colecistite( in questo caso enfisematosa).La colecistite determina parziale relaxatio diaframmatica, piccolo versamento pleurico e strie disatellettasiche alla base polmonare corrispondente.

    7. ashraf abohadeed says:

      dear professor
      do you allow me to collect your cases in power point presentation and put here ??
      thank you ashraf