Submitted by Dr KS Tang, ICU, Tuen Mun Hospital, 15 June 2010
Figure 1. Click Read More for a larger image
A 70-year-old mle who was well all along except being a chronic heavy drinker was admitted for cough and yellowish sputum. CXR showed massive left effusion (figure 1). Pigtail drainage was done (around 800ml effusion was drained).
Figure 1. Pre-drainage CXR
Post-drainage CXR showed similar picture (Figure 2).
Figure 2. Post-drainage CXR
USG thorax showed minimal effusion only, and massive collapse changes was noted. The image was taken from lower back on left side (figure 3). There is no USG sign of air bronchogram (hyperechoic punctate shadows) that are air filed bronchi.
Figure 3. USG thorax
Question: Would you put in a second drain? (Answer pending)