Year : 2014  |  Volume : 8  |  Issue : 2  |  Page : 87-90

Can transthoracic ultrasound differentiate between simple and obstructed pneumonia?

Chest Department, Assiut University Hospital, Assiut, Egypt

Correspondence Address:
Randa E Abd Elkader
Chest Department, Assiut University Hospital, Assiut
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1687-8426.145695

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Background The advantages of low cost, bedside availability, and no radiation exposure have made ultrasound an indispensable diagnostic tool in modern pulmonary medicine. Color Doppler ultrasound demonstrates normal or increased flow in the normal vessels of the consolidated lung and may be helpful in distinguishing simple pneumonia from postobstructive pneumonia. Aim of the work The aim of this work was to describe sonographic features of simple and obstructed pneumonia and discuss the value of transthoracic ultrasound to differentiate between both diseases. Results The study included 18 patients with simple pneumonia and seven patients with obstructed pneumonia. The sonographic findings were as follows: positive air bronchogram recorded in 100% of the cases of simple pneumonia, but not found in any case of obstructed pneumonia; fluid bronchogram not found in any case of simple pneumonia and present in 100% of obstructed pneumonia (P = 0.005). Oval and rounded shape, irregular shape, sharp well-demarcated, blurred-border, homogenous, heterogeneous, and hypoechoic echo patterns were found in 38.9, 61.1, 33.3, 66.7, 11.1, 88.9, and 100% of the cases of simple pneumonia and in 42.9, 57.1, 28.6, 71.4, 0, 100, and 85.7% of the cases of obstructed pneumonia, respectively. Pleural effusion was present in 44.4 and 42.9% of cases of simple and obstructed pneumonia, respectively. Fluid bronchogram was seen in the bronchial obstruction, as a result of either impacted secretions or a proximal tumor. Conclusion The presence of signs of fluid bronchogram in the appropriate clinical context should raise the suspicion of postobstructive pneumonitis. Transthoracic ultrasound helps in distinguishing the central obstructing tumor as a hypoechoic mass from distal more echogenic consolidations.

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