PMC9035965_01
Chest X-ray obtained in ED demonstrating large left pleural effusion and moderate-to-large right pleural effusion.
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F1
Chest X-ray demonstrated large left pleural effusion and moderate to large right pleural effusion, with predominantly perihilar alveolar opacities (Fig. 1).
CT thorax with contrast post-thoracentesis demonstrating large left hydropneumothorax and large right pleural effusion. Scattered patchy ground-glass opacities and large posteroinferior mediastinal fluid also demonstrated.
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F2
CT was done after the left thoracentesis that demonstrated the expansion of the moderate to large right pleural effusion and new development of left hydropneumothorax, along with a large posteroinferior mediastinal fluid/mass that could represent pleural and pericardial or pancreatic fluid (Fig. 2). CT of the abdomen was notable for enlargement of the pancreatic duct and a stable pancreatic pseudocyst.
Chest X-ray demonstrating loculated left pneumothorax with concern for trapped lung (arrows).
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F3
Subsequent chest X-ray demonstrated slightly worsened hydropneumothorax, concerning for a persistent trapped lung with ex vacuo findings (Fig. 3).