Clinical presentation of pulmonary edema following esophagectomy on chest radiograph.

OBJECTIVE

To determine whether the clinical presentation of pulmonary edema following esophagectomy can be objectively determined by changes in X-ray density in the lung field on chest radiography.

METHODS

Sixteen patients who underwent esophagectomy for thoracic esophageal cancer and five patients who underwent less radical surgery at Akita University Hospital between July 2000 and March 2001 were recruited to the thoracic esophageal cancer and control groups, respectively. Chest radiography was carried out using five aluminum disks (15, 20, 25, 30 and 35 mm thickness) placed in upper right corner of the film and X-ray density for the disks and chest lung field was measured using a densitometer until POD 7.

RESULTS

In the thoracic esophageal cancer group, X-ray density in the lung field, body weight, and respiratory index increased significantly in the immediate postoperative period. The X-ray density in the lung field peaked on POD 2, and remained constant to POD 6. Correlations were found among changes in X-ray density in the lung field, body weight, and respiratory index.

CONCLUSIONS

The measurement of X-ray density on a chest radiograph is useful for prediction as well as early management of patients with pulmonary edema following esophagectomy for thoracic esophageal cancer.