Fleischner sign ( pulmonary )

 

CLINICAL PRESENTAION:

47 year old male status post urethroplasty 4 days back , developed acute sudden chest pain that subsided after few minutes but the patient continue to have shortness of breath.  

FINDINGS:

The portable chest radiography demonstrate premiant right inferior pulmonary artery ( Fleishner's sign ) with abrupt caliber change ( Chang's sign ) highly suggestive of acute pulmonary embolism.

The patient has a previous radiograph, one year back ; which demonstrate normal pulmonary artery size. 

 CTPA demonstrate bilateral main pulmonary arteries filling defects in keeping with acute pulmonary embolism.