Pleural effusion with complete right lower lobe collapse

Case contributed by Dr M Osama Yonso

Presentation

A 75 Y/O male with shortness of breath, and he had a history of cardiac operation 10 years ago

Patient Data

Age: 75 y
Gender: Male

Massive opacity right hemithorax, no shift of trachea and heart, smaller right hemithorax, right heart and diaphragmatic silhouettes are not identifiable, marks indicates to heart surgery. 

Modality: Ultrasound

Right pleural effusion with right lower lobe atelectasis

CT shows huge right pleural effusion with majority RT lung atelectasis  

Control after Puncture of pleural fluid

Modality: X-ray

PA  chest x- ray shows right pleural effuision with a few air-fluid  levels with a view looks like a Golden S sign 3 but is inverted, this may indicates to  central bronchial tumor that caused lower lobe atelectasis  of the right lung 

Case Discussion

Chest x-rays are the most commonly used examination to assess for presence of a pleural effusion. 

Ultrasound allows the detection of small amounts of pleural locular fluid, with positive identification of amounts as small as 3 to 5 ml, that cannot be identified by x-rays, which is only capable of detecting volumes above 50 ml of liquid.

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Case Information

rID: 25128
Case created: 6th Oct 2013
Last edited: 1st Mar 2016
System: Chest
Inclusion in quiz mode: Included

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