Dr Grace SM Lam, ICU, Pamela Youde Nethersole Eastern Hospital. 26 May 2010
A 79-year old man complained of productive cough and right pleuritic pain. CXR showed right pleural effusion. Initial diagnostic and therapeutic thoracentesis revealed lymphocyte-predominant pleural fluid, cytology and AFB smear were negative. He developed rapid reaccumulation of effusion and was admitted ICU for respiratory failure. Medical thoracoscopy (MT) was done. This is the first reported case of MT done within the ICU in Hong Kong.
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Change to a double-lumen Broncho-Cath
USG thorax to ascertain best position for insertion
Trocar port inserted, pleural fluid gushed out and stopped by thumb
Yellowish and viscous pleural fluid
Pleurscopy inserted by Dr Grace Lam
Procedure finished, chest drain inserted and being secured
Change back to a usual endotracheal tube