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PrISM Respiratory

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In the normal situation, shown in Image B, both diaphragms are usually at about the same level. The right diaphragm (blue) may be very slightly higher than the left, partly due to pressure upward from the liver. The left diaphragm (green) is usually very slightly lower than the right due to downward pressure from the heart. The lucency below the left hemidiaphragm (purple) is again gas in the stomach.

In our patient in Image A, the left (red) is much higher than the right (blue), which is different from the normal patient in Image B. The purple indicates gas in the stomach, which is normal. What do you think might be causing the abnormality indicated by the yellow marks? What could cause the diaphragms to look this way?

A

B

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