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Clinical introduction
A man in his 60s who had recently moved to the area attended a preoperative appointment for a cholecystectomy. He reported to be asymptomatic. He had a past medical history of hypertension and took Amlodipine and had no known allergies. A chest X-ray was performed as part of the workup (figure 1).
Preoperative chest X-ray
What is the cause of abnormalities seen on the image?
Prominent pericardial fat pad only
Bilateral healed rib fractures
Pneumoperitoneum
Aortic coarctation
Lung cancer
Answer: D
The correct answer is D, as there is evidence of bilateral inferior rib notching (online supplemental figure 1—white chevron) as well as an absent aortic knuckle (online supplemental figure 1 …
Footnotes
Contributors MS and BR came up with the concept and prepared the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.
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