CT Scan shows one lung flat on bottom

[alchemyst]

My husband (age 69) has been ill for the last 4 days, with acute pain the lower right quandrant, which was initially put down to a kidney stone.  Further investigation with a CT Scan did NOT show stones - and he has been given pain meds and an anti-infammatory for 'inflammation'.

When they did the CT Scan to check for kidney stones - it showed that one of his lungs is FLAT on the bottom.

WHAT does this mean?

He's a reformed smoker - quit cold turkey, 30 years ago when our son was born.  He has no overt respiratory symptoms.

Please help?

[National Jewish Health]

You should ask your husband’s doctors if the CT imaging technique used is capable of visualizing stones of all composition, including uric acid stones.  If not, the initial diagnosis of “kidney stones” could still be the correct diagnosis.

The detection of one of his lungs being “flat” on the bottom probably means that the hemidiaphragm is flattened.  It could indicate hyperinflation, as can be seen with emphysema, more prominent in the “flat lung” than the other or partial obstruction of a bronchus of the “flat lung”.  It could also appear to be flat, in comparison to the other hemidaphragm being elevated.  The radiologist should be asked to provide a differential diagnosis of the flattening and you may want to seek consultation with a lung specialist, if all others agree that the hemidiaphragm is truly “flat.”

Good luck.

[alchemyst]

Thank you 'askingyou' for taking the time to respond.

Yes, that is what the ER doctor said - the CT Scan showed that one lung (his right one) is 'flat on the bottom'.  I asked if it was fluid, she said no - though apparently there is a 'very small amount of fluid' in there as well.  I asked if it was a mass of some kind, and again, she said no. But she was quite emphatic that he see our family doctor to have (the flat lung issue) followed up.

For the acute pain in the right quadrant - They did blood tests for kidney and liver function, and urinalysis. Also, a regular Xray in the ER, the night before they did the CT Scan - and that first night they gave him a cocktail of morphine, toradol, gravol and flomax. Of course with all that on board the pain subsided - temporarily.

The urinalysis, that first night, showed a small amount of blood in the urine - which is why she seemed (at the time) quite certain it would be a kidney stone.  The other tests all came back 'fine'. Then, following day they did the CT Scan and NO stone showed up.

She said that "everything" they could see on the CT Scan looked "normal" with the exception of this flat-bottom lung issue.  The bowel showed only normal stool, and the spine was 'fine'.

He had his appendix out when he was a kid, so we knew it wouldn't be that, altho the pain is in just the right area to BE appendix, and the caliber of pain the same, too.

So, now he's days into this, and he's still in pain. He says it is a grinding dull and exhausting ache, that soars to an 8 out of 10 when he moves - or (oddly enough) when he lays flat. He can't lay on either side in bed without the pain soaring - which makes me wonder if its possibly bowel related - even though she thought the bowel was normal on the CT.

The ER doc was great as long as she thought it was a kidney stone - but once no stones showed on CT, she seemed to lose interest, and has advised us to see our family doc for anything further.

In fairness to her, I know she's limited in what she can do in the ER - but he was in such pain at the time, (and still is) - it felt a little like the brush-off.   She prescribed an anti-flammatory that specifically targets the urinary tract, and gave him a scrip for 20 toradol. (There was NO sign of UTI)

He worked construction all his life (this is his first week of retirement, believe it or not - a great start! lol) - and has always been strong and healthy and 'tough' - so when he even admits he's hurting, its an event - let alone when he wakes me, groaning in pain.

So - I have no idea whether this lung that is flat on the bottom, is connected to the acute ab pain - or if its a seperate issure entirely.  

I asked her if the ab pain, could be referred pain  - and she said, if it was, it would be from the back/spine - and that his spine was 'good' on the CT scan.

I called for an appt with our family doc this morning and had to fight to get him in - they've tacked him on to the end of the day, so he's got all day again to wait in pain.

They did not check his gallbladder or for ulcers, (that I know of ) - unless these would show on a CT Scan - and if so, she didn't mention either.

A frustrating situation - as once kidney stones did NOT show on CT - it seemed like she discounted the pain entirely (which WAS the issue that brought us to the ER in the first place) - and focussed on this flat-bottom lung thing.  If she thought the lung issue was connected to the ab pain - its a mystery why she didn't investigate it then and there.

I too hope they find the cause ... I'm not used to seeing him 'down for the count' like this ... his face goes just grey with the pain.

Thanks again for responding - sorry for the length of this ...

[askingyou]

Is that what they told you?   Flat on the bottom?  Or a Pnuemothorax?

Did they check his gall bladder?

Or for a duodenal Ulcer?  

Hope they find the cause.