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LOCALIZED PULMONARY EDEMA FOLLOWING SURGICALLY CREATED LEFT-TO-RIGHT SHUNTS

R. WESLEY MUTCHLER JR. M.D., JUDITH S. ROSE M.D., ANTONIO A. GARZON M.D., ROBERT EHRLICH M.D., and DAVID C. LEVIN M.D.

The roentgen appearance of localized postoperative pulmonary edema in patients who have undergone palliative systemic-pulmonary shunt surgery is discussed.

Unilateral whole lung edema may occur, as well as previously undescribed congestive changes isolated to the right upper lobe in post-Waterston shunt patients.

The presence of a bulging fissure, in addition to parenchymal infiltrate, is important in differentiation of the above from pneumonitis or atelectasis. The cause of this is felt to be preferential distribution of flow, in most cases, from the shunt itself to the ipsilateral lung or one of its lobes on segments.

Prompt recognition of this particular postoperative problem is essential for the successful management of these patients.


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