The chest radiograph on admission revealed an area of hyperlucency containing air-fluid level
in the lower 1/3 of the right lung area and an area of opacity in the lower 1/2 of the right hemithorax, with concave superior interface border (Figure 2).
She was then referred to the Division of Pediatric Gastroenterology with a prediagnosis of inflammatory bowel disease because air-fluid level
was not found on plain erect abdominal radiography and there was a history of weight loss.
Scoliosis to the right side, localized air-fluid level
or gas deposition on the right lower quadrant, and fecalith on standing abdominal X-ray were noted.
Computed tomography (CT) (Figure 3) and magnetic resonance imaging (MRI) revealed a cystic lesion with air-fluid level
, approximately 60 x 50 mm in size, on the left side of the neck, which extended from the epipharynx to the superior mediastinum.
Chest X-ray (CXR) (PA and lateral views) in the emergency department revealed a cavitary lesion with an air-fluid level
within the anterior medial right hemithorax and a loculated hydropneumothorax along the right lateral lung base (Figure 1).
Cavitation and air-fluid level
(Figure 2) were more frequent in nodules over one centimeter (29.4% versus 8.8% for cavitation and 8.8% versus 2.9% for air-fluid level
Pneumopericardium is defined as the presence of an air-fluid level
in the pericardial sac .
A plain radiograph (Waters view) revealed no signs of sinusitis, such as mucosal thickness or an air-fluid level
The plain film findings of acute sinusitis include mucosal thickening, an air-fluid level
and partial or total sinus opacification of paranasal sinuses.
Sagittal contrast-enhanced T1-weighted image (C) show air-fluid level
in the cystic lesion suggestive of abscess cavity probably associated with air-forming bacterial infection.
The diagnosis of hydropneumopericardium requires the application of Shackelford criteria which include (i) high-pitched tympanic percussion note, (ii) loud metallic splashing sound synchronous with heart sounds, and (iii) characteristic chest X-ray with an air-fluid level
in the pericardial cavity.(1)