neonatal chest x-ray in the exam setting.pediatric chest x-ray in the exam setting.osteophyte induced adjacent pulmonary atelectasis and fibrosis.chronic bilateral airspace opacification (differential).chronic unilateral airspace opacification (differential).acute airspace opacification with lymphadenopathy (differential).acute bilateral airspace opacification (differential).acute unilateral airspace opacification (differential).differential diagnoses of airspace opacification.differential of left paramediastinal catheter positions.peripherally inserted central catheters.evaluation of endotracheal tube position.evaluation of nasogastric tube position.in a tension gastrothorax there is an absence of the gastric bubble, a key differentiating point between it and a left-sided tension pneumothorax.small studies have linked gastric bubble shapes to the presence of gastroesophageal reflux, however, this is not a well-established relationship.gastric volvulus may result in an altered appearance of the gastric bubble.in splenomegaly, the gastric bubble may be displaced towards the midline, however, the significance of this finding has been debated. a left-sided pleural effusion or subpulmonic effusion may cause increased distance between lower lobe air and gastric bubble.In situs inversus, the normal gastric bubble is located under the right hemidiaphragm. It is seen on approximately 70% of normal chest radiographs.Īn important differential is pneumoperitoneum, which is usually easily distinguishable as a thin radiolucent crescent under the hemidiaphragm. It can be seen on chest or abdominal plain films. On a lateral radiograph, the gastric bubble is usually located between the abdominal wall and spine. The gastric bubble is a radiolucent rounded area generally nestled under the left hemidiaphragm representing gas in the fundus of the stomach.
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