PMC6206516_01
Large Left-Sided pleural effusion with tracheal deviation to the contralateral side. Also sternal wires from previous open-heart surgery are noted.
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Chest radiograph (CXR) showed opacification of two-thirds of the left hemithorax with tracheal deviation to the contralateral side consistent with pleural effusion (Figure 1).
Pleural fluid sample. Of note, the whole amount of the drained fluid (1 liter) had the same color and consistency and did not clear by the end of drainage.
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One liter of bloody fluid was drained and sent for testing (Figure 2).
Chest CT with IV contrast after drainage of one liter. No vascular malformations, active bleeding, or other sources of hemothorax were identified. Left-sided pleural effusion was noted to have different Hounsfield unit when compared to the aorta and pulmonary artery.
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A chest computed tomography (CT) with intravenous contrast was done to rule out active bleeding, vascular malformations, and other causes of spontaneous hemothorax (Figure 3).
Near-total resolution of left-sided pleural effusion. Left-sided Pigtail (12-Fr) catheter and sternal wires are noted as well.
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CXR after drainage showed near-total resolution of the pleural effusion (Figure 4).