The Common Vein

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Westermark’s Sign



 This a plain film and a CT of a 61 year male with non small cell carcinoma treated 9 months prior and a recent admission to an outside institution with MRSA. he was transferred to current hospital due to worsening blood gases and CTA showed complete occlusion of the left pulmonary artery. Dopller showed DVT of the right popliteal vein. He had a subsequent episode of worsening of blood gases and a chest X-ray showed a complte white out of the right lung and a mid region (upper triangle in b) of a paucity of blood vessels. This is known as Westermark’s sign. The white out on the right side was thought to be due to aspiration. He thus had no ventilation of the right lung and almost no perfusion of the left lung. He was bronchoscoped and thick secretions were removed from the right bronchus. Despite treatment on anticoagulants and repeated bronchospies the patient unfortunately expired.
lung bronchus Westermark’s sign PE pulmonary embolus massive aspiration pneumonia CTscan chest X-ray CXR Courtesy Ashley Davidoff MD copyright 2009 all rights reserved86265c02.8s



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Westermark’s Sign



 This a plain film and a CT of a 61 year male with non small cell carcinoma treated 9 months prior and a recent admission to an outside institution with MRSA. he was transferred to current hospital due to worsening blood gases and CTA showed complete occlusion of the left pulmonary artery. Dopller showed DVT of the right popliteal vein. He had a subsequent episode of worsening of blood gases and a chest X-ray showed a complte white out of the right lung and a mid region (upper triangle in b) of a paucity of blood vessels. This is known as Westermark’s sign. The white out on the right side was thought to be due to aspiration. He thus had no ventilation of the right lung and almost no perfusion of the left lung. He was bronchoscoped and thick secretions were removed from the right bronchus. Despite treatment on anticoagulants and repeated bronchospies the patient unfortunately expired.
lung bronchus Westermark’s sign PE pulmonary embolus massive aspiration pneumonia CTscan chest X-ray CXR Courtesy Ashley Davidoff MD copyright 2009 all rights reserved86265c02.8s



)

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lung bronchus Westermark’s sign PE pulmonary embolus massive aspiration pneumonia CTscan chest X-ray CXR Courtesy Ashley Davidoff MD copyright 2009 all rights reserved86265c02.8s
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lung bronchus Westermark’s sign PE pulmonary embolus massive aspiration pneumonia CTscan chest X-ray CXR Courtesy Ashley Davidoff MD copyright 2009 all rights reserved86265c02.8s
)

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Westermark’s Sign



 This a plain film and a CT of a 61 year male with non small cell carcinoma treated 9 months prior and a recent admission to an outside institution with MRSA. he was transferred to current hospital due to worsening blood gases and CTA showed complete occlusion of the left pulmonary artery. Dopller showed DVT of the right popliteal vein. He had a subsequent episode of worsening of blood gases and a chest X-ray showed a complte white out of the right lung and a mid region (upper triangle in b) of a paucity of blood vessels. This is known as Westermark’s sign. The white out on the right side was thought to be due to aspiration. He thus had no ventilation of the right lung and almost no perfusion of the left lung. He was bronchoscoped and thick secretions were removed from the right bronchus. Despite treatment on anticoagulants and repeated bronchospies the patient unfortunately expired.
lung bronchus Westermark’s sign PE pulmonary embolus massive aspiration pneumonia CTscan chest X-ray CXR Courtesy Ashley Davidoff MD copyright 2009 all rights reserved86265c02.8s



Westermark’s




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Westermark’s Sign



 This a plain film and a CT of a 61 year male with non small cell carcinoma treated 9 months prior and a recent admission to an outside institution with MRSA. he was transferred to current hospital due to worsening blood gases and CTA showed complete occlusion of the left pulmonary artery. Dopller showed DVT of the right popliteal vein. He had a subsequent episode of worsening of blood gases and a chest X-ray showed a complte white out of the right lung and a mid region (upper triangle in b) of a paucity of blood vessels. This is known as Westermark’s sign. The white out on the right side was thought to be due to aspiration. He thus had no ventilation of the right lung and almost no perfusion of the left lung. He was bronchoscoped and thick secretions were removed from the right bronchus. Despite treatment on anticoagulants and repeated bronchospies the patient unfortunately expired.
lung bronchus Westermark’s sign PE pulmonary embolus massive aspiration pneumonia CTscan chest X-ray CXR Courtesy Ashley Davidoff MD copyright 2009 all rights reserved86265c02.8s



Westermark’s




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lung bronchus Westermark’s sign PE pulmonary embolus massive aspiration pneumonia CTscan chest X-ray CXR Courtesy Ashley Davidoff MD copyright 2009 all rights reserved86265c02.8s
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lung bronchus Westermark’s sign PE pulmonary embolus massive aspiration pneumonia CTscan chest X-ray CXR Courtesy Ashley Davidoff MD copyright 2009 all rights reserved86265c02.8s
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Westermark’s Sign



 This a plain film and a CT of a 61 year male with non small cell carcinoma treated 9 months prior and a recent admission to an outside institution with MRSA. he was transferred to current hospital due to worsening blood gases and CTA showed complete occlusion of the left pulmonary artery. Dopller showed DVT of the right popliteal vein. He had a subsequent episode of worsening of blood gases and a chest X-ray showed a complte white out of the right lung and a mid region (upper triangle in b) of a paucity of blood vessels. This is known as Westermark’s sign. The white out on the right side was thought to be due to aspiration. He thus had no ventilation of the right lung and almost no perfusion of the left lung. He was bronchoscoped and thick secretions were removed from the right bronchus. Despite treatment on anticoagulants and repeated bronchospies the patient unfortunately expired.
lung bronchus Westermark’s sign PE pulmonary embolus massive aspiration pneumonia CTscan chest X-ray CXR Courtesy Ashley Davidoff MD copyright 2009 all rights reserved86265c02.8s



Westermark’s

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Westermark’s Sign



 This a plain film and a CT of a 61 year male with non small cell carcinoma treated 9 months prior and a recent admission to an outside institution with MRSA. he was transferred to current hospital due to worsening blood gases and CTA showed complete occlusion of the left pulmonary artery. Dopller showed DVT of the right popliteal vein. He had a subsequent episode of worsening of blood gases and a chest X-ray showed a complte white out of the right lung and a mid region (upper triangle in b) of a paucity of blood vessels. This is known as Westermark’s sign. The white out on the right side was thought to be due to aspiration. He thus had no ventilation of the right lung and almost no perfusion of the left lung. He was bronchoscoped and thick secretions were removed from the right bronchus. Despite treatment on anticoagulants and repeated bronchospies the patient unfortunately expired.
lung bronchus Westermark’s sign PE pulmonary embolus massive aspiration pneumonia CTscan chest X-ray CXR Courtesy Ashley Davidoff MD copyright 2009 all rights reserved86265c02.8s



Westermark’s

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Westermark’s Sign



 This a plain film and a CT of a 61 year male with non small cell carcinoma treated 9 months prior and a recent admission to an outside institution with MRSA. he was transferred to current hospital due to worsening blood gases and CTA showed complete occlusion of the left pulmonary artery. Dopller showed DVT of the right popliteal vein. He had a subsequent episode of worsening of blood gases and a chest X-ray showed a complte white out of the right lung and a mid region (upper triangle in b) of a paucity of blood vessels. This is known as Westermark’s sign. The white out on the right side was thought to be due to aspiration. He thus had no ventilation of the right lung and almost no perfusion of the left lung. He was bronchoscoped and thick secretions were removed from the right bronchus. Despite treatment on anticoagulants and repeated bronchospies the patient unfortunately expired.
lung bronchus Westermark’s sign PE pulmonary embolus massive aspiration pneumonia CTscan chest X-ray CXR Courtesy Ashley Davidoff MD copyright 2009 all rights reserved86265c02.8s



Westermark’s








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Westermark’s Sign



 This a plain film and a CT of a 61 year male with non small cell carcinoma treated 9 months prior and a recent admission to an outside institution with MRSA. he was transferred to current hospital due to worsening blood gases and CTA showed complete occlusion of the left pulmonary artery. Dopller showed DVT of the right popliteal vein. He had a subsequent episode of worsening of blood gases and a chest X-ray showed a complte white out of the right lung and a mid region (upper triangle in b) of a paucity of blood vessels. This is known as Westermark’s sign. The white out on the right side was thought to be due to aspiration. He thus had no ventilation of the right lung and almost no perfusion of the left lung. He was bronchoscoped and thick secretions were removed from the right bronchus. Despite treatment on anticoagulants and repeated bronchospies the patient unfortunately expired.
lung bronchus Westermark’s sign PE pulmonary embolus massive aspiration pneumonia CTscan chest X-ray CXR Courtesy Ashley Davidoff MD copyright 2009 all rights reserved86265c02.8s



Westermark’s








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lung bronchus Westermark’s sign PE pulmonary embolus massive aspiration pneumonia CTscan chest X-ray CXR Courtesy Ashley Davidoff MD copyright 2009 all rights reserved86265c02.8s
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lung bronchus Westermark’s sign PE pulmonary embolus massive aspiration pneumonia CTscan chest X-ray CXR Courtesy Ashley Davidoff MD copyright 2009 all rights reserved86265c02.8s
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Westermark’s Sign



 This a plain film and a CT of a 61 year male with non small cell carcinoma treated 9 months prior and a recent admission to an outside institution with MRSA. he was transferred to current hospital due to worsening blood gases and CTA showed complete occlusion of the left pulmonary artery. Dopller showed DVT of the right popliteal vein. He had a subsequent episode of worsening of blood gases and a chest X-ray showed a complte white out of the right lung and a mid region (upper triangle in b) of a paucity of blood vessels. This is known as Westermark’s sign. The white out on the right side was thought to be due to aspiration. He thus had no ventilation of the right lung and almost no perfusion of the left lung. He was bronchoscoped and thick secretions were removed from the right bronchus. Despite treatment on anticoagulants and repeated bronchospies the patient unfortunately expired.
lung bronchus Westermark’s sign PE pulmonary embolus massive aspiration pneumonia CTscan chest X-ray CXR Courtesy Ashley Davidoff MD copyright 2009 all rights reserved86265c02.8s



Westermark’s

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Westermark’s Sign



 This a plain film and a CT of a 61 year male with non small cell carcinoma treated 9 months prior and a recent admission to an outside institution with MRSA. he was transferred to current hospital due to worsening blood gases and CTA showed complete occlusion of the left pulmonary artery. Dopller showed DVT of the right popliteal vein. He had a subsequent episode of worsening of blood gases and a chest X-ray showed a complte white out of the right lung and a mid region (upper triangle in b) of a paucity of blood vessels. This is known as Westermark’s sign. The white out on the right side was thought to be due to aspiration. He thus had no ventilation of the right lung and almost no perfusion of the left lung. He was bronchoscoped and thick secretions were removed from the right bronchus. Despite treatment on anticoagulants and repeated bronchospies the patient unfortunately expired.
lung bronchus Westermark’s sign PE pulmonary embolus massive aspiration pneumonia CTscan chest X-ray CXR Courtesy Ashley Davidoff MD copyright 2009 all rights reserved86265c02.8s



Westermark’s

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Westermark’s Sign



 This a plain film and a CT of a 61 year male with non small cell carcinoma treated 9 months prior and a recent admission to an outside institution with MRSA. he was transferred to current hospital due to worsening blood gases and CTA showed complete occlusion of the left pulmonary artery. Dopller showed DVT of the right popliteal vein. He had a subsequent episode of worsening of blood gases and a chest X-ray showed a complte white out of the right lung and a mid region (upper triangle in b) of a paucity of blood vessels. This is known as Westermark’s sign. The white out on the right side was thought to be due to aspiration. He thus had no ventilation of the right lung and almost no perfusion of the left lung. He was bronchoscoped and thick secretions were removed from the right bronchus. Despite treatment on anticoagulants and repeated bronchospies the patient unfortunately expired.
lung bronchus Westermark’s sign PE pulmonary embolus massive aspiration pneumonia CTscan chest X-ray CXR Courtesy Ashley Davidoff MD copyright 2009 all rights reserved86265c02.8s



Westermark’s





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Westermark’s Sign



 This a plain film and a CT of a 61 year male with non small cell carcinoma treated 9 months prior and a recent admission to an outside institution with MRSA. he was transferred to current hospital due to worsening blood gases and CTA showed complete occlusion of the left pulmonary artery. Dopller showed DVT of the right popliteal vein. He had a subsequent episode of worsening of blood gases and a chest X-ray showed a complte white out of the right lung and a mid region (upper triangle in b) of a paucity of blood vessels. This is known as Westermark’s sign. The white out on the right side was thought to be due to aspiration. He thus had no ventilation of the right lung and almost no perfusion of the left lung. He was bronchoscoped and thick secretions were removed from the right bronchus. Despite treatment on anticoagulants and repeated bronchospies the patient unfortunately expired.
lung bronchus Westermark’s sign PE pulmonary embolus massive aspiration pneumonia CTscan chest X-ray CXR Courtesy Ashley Davidoff MD copyright 2009 all rights reserved86265c02.8s



Westermark’s





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