Today’s case is a rare condition where there is transposition of a loop of large intestine (usually transverse colon/hepatic flexure of the colon) in between the right diaphragm and the liver, as seen in on plain abdominal X-ray or chest X-ray. It is said that this seen in only about 0.1-1.0% of chest x-rays.

Observation

Clinical History: Pre-op

Technique: DX chest 2 views

The cardiomediastinal silhouette appears to be within normal limits. The lungs are hyperexpanded with flatteing of the hemidiaphragms. No acute focal infiltrate or consolidation is seen. There is presence of an air-filled bowel loop, between the liver and right hemidiaphragm, which is usually of no clinical significance.

Impression

CLEAR CHEST. CONSIDER COPD. OTHER FINDINGS AS NOTED ABOVE.