Re-expansion pulmonary edema

Case contributed by Henry Knipe
Diagnosis probable


Shortness of breath. History of cancer.

Patient Data

Age: 80-90 years
Gender: Male

Right pleural effusion with associated compressive atelectasis. Small left pleural effusion. Left upper zone mass. Sternotomy wires and valve replacement. Enlarged cardiac silhouette. 

The patient underwent an ultrasound-guided pleural tap with 1500 mL of straw yellow pleural fluid drained. No complications at the time of procedure. 

Post procedure x-ray


Right pleural effusion has been drained. No pneumothorax. 

Three hours after the procedure, the patient deteriorated with tachypnea. A MET call was made and a portable chest x-ray was performed. 

Three hours later


New right mid to lower zone consolidation. No reaccumulation of the right pleural effusion. 

Case Discussion

The main differential in this patient for the rapid development of consolidation on the right of pleural tap is re-expansion pulmonary edema and pulmonary hemorrhage. The patient had no hemoptysis and the pleural tap was uncomplicated and image-guided making the former more likely. 

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