Kedia Yash, Gupta Nitesh, Kumar Rohit
Department of Pulmonary Medicine, Critical Care and Sleep Medicine Vardhman Mahavir Medical College and Safdarjung Hospital New Delhi India.
Australas J Ultrasound Med. 2025 Jan 9;28(1):e12418. doi: 10.1002/ajum.12418. eCollection 2025 Feb.
Ultrasound has become an important aspect of emergency medicine due to its wide availability and portability for bedside investigations. Understanding some important ultrasound findings can aid in diagnosis and management.
We present a case of a 65-year-old smoker who presented with shortness of breath and hemoptysis and was in respiratory failure upon arrival in the emergency department. Bedside ultrasound demonstrated a fluid bronchogram, aiding the diagnosis of lung collapse secondary to endobronchial obstruction.
Fluid bronchograms are seen on CT chest and ultrasonography as linear images corresponding to dilated bronchus, filled with mucus, distal to an endobronchial obstruction. They are characterised by anechoic, tubular structures, suggestive of fluid filled bronchi, over the hypoechogenic pulmonary parenchyma, and can be differentiated from blood vessels by the lack of Doppler signal. Ultrasonographic image of fluid bronchogram is very unique and can help to detect collapse secondary to endobronchial obstruction using point-of-care ultrasonography in emergency.
由于超声具有广泛的可用性且便于床旁检查,已成为急诊医学的一个重要方面。了解一些重要的超声检查结果有助于诊断和治疗。
我们报告一例65岁吸烟者,因呼吸急促和咯血就诊,到达急诊科时已出现呼吸衰竭。床旁超声显示液性支气管征,有助于诊断支气管内阻塞继发的肺不张。
在胸部CT和超声检查中,液性支气管征表现为与扩张支气管相对应的线性影像,支气管内阻塞远端充满黏液。其特征为无回声管状结构,提示充满液体的支气管位于低回声肺实质之上,且可通过缺乏多普勒信号与血管相鉴别。液性支气管征的超声图像非常独特,可在急诊中利用床旁超声检查发现支气管内阻塞继发的肺不张。