|Year : 2016 | Volume
| Issue : 1 | Page : 95-96
Mediastinal widening: An interesting quiz
Rakesh K Chawla1, Arun Madan2, Aditya Chawla3, Kiran Chawla4
1 Department of Respiratory Medicine, Critical Care and Sleep Disorders, Jaipur Golden Hospital, Delhi, India
2 Department of Pulmonary Medicine, Sharda Medical College and Hospital, Sharda University, Noida, India
3 Department of Pulmonary Medicine, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India
4 Department of Hospital Management, Singhania University, Rajasthan, India
|Date of Web Publication||4-Jan-2016|
Rakesh K Chawla
Chawla Respiratory, Allergy, Sleep Disorder and Research Centre, 58-59/C-12/Sector-3, Rohini, Delhi - 110 085
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Chawla RK, Madan A, Chawla A, Chawla K. Mediastinal widening: An interesting quiz. Lung India 2016;33:95-6
| Case History|| |
A 60-year-old non-smoker obese female and a known diabetic was admitted to a tertiary care hospital with altered sensorium. She complained of fatigue, nausea, polydypsia, polyuria and shortness of breath. She was awake but confused; her speech, vision and deglutition reflexes were normal. Her pulse rate was 110/minute, regular with good volume, BP 102/72 mmHg, respiratory rate 24/minute and oxygen saturation of 97% on room air. Respiratory and cardiac examinations did not reveal any abnormality. Overall, she was clinically stable. There were no engorged neck veins, tender hepatomegaly, dependent edema, distended superficial veins, or other evidences of cardiac or hepatic disease. Also, there was absence of headache, epistaxis, visual disturbances, hoarseness of voice, tongue swelling, hemetemesis or hemoptysis. Blood analysis (including a hemogram, differential cell count, hepatic and renal functions) was within normal limits. ECG showed regular tracings. USG abdomen did not show any organomegaly or fluid in serous membranes. Her random blood sugar was 440 mg%; pH 7.3, pCO2 32 mmHg and HCO3– was 18 meq/L. Ketone bodies were positive on urine exam. She was managed on the lines of DKA with IV insulin infusion @ 8 IU/hour, 2 liters of saline in first 2 hours followed by remaining 2 liters in 24 hours along with potassium supplementation and recovered completely. Incidentally, however, her routine chest radiograph showed right mediastinal opacity with widening of the mediastinum mimicking a mediastinal tumor [Figure 1].
| Question|| |
What is the diagnosis?
| References|| |
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[Figure 1], [Figure 2]