Think Outside the Box: A Unique Approach to the Management of Comorbid Malignant Pleural Effusions скачать в хорошем качестве

Think Outside the Box: A Unique Approach to the Management of Comorbid Malignant Pleural Effusions

Ultrasound Corner: Think Outside the Box: A Unique Approach to the Management of Comorbid Malignant Pleural and Pericardial Effusions Case Presentation: A 42-year-old man with recently diagnosed stage IV lung adenocarcinoma presented to the hospital with dyspnea and presyncope. During his index hospitalization earlier that year, he presented with pericardial tamponade. He was found to have extensive pleural/pericardial metastasis and had previously undergone both a left thoracoscopic pericardial window and placement of a left basilar indwelling pleural catheter (IPC) for outpatient effusion management. In the emergency department during this visit, he was found to be hypotensive with pulsus paradoxus and echocardiographic findings suggestive of a recalcitrant episode of tamponade (Video 1). His IPC was additionally found to be dysfunctional due to pleurodesis of the surrounding pleura, and CT scan demonstrated interval development of a multiloculated pleural effusion and moderate pericardial effusion (e-Fig 1). Questions: What is the most appropriate imaging modality to assess the size/location of his pericardial window and its relationship to his pleural effusion? What management strategies could be implemented in the care of this patient? Can serial thoracentesis safely manage both pleural and postwindow pericardial effusions? What's the diagnosis? Read the full article in the September 2025 issue of #journal_CHESTPulm: http://www.doi.org/10.1016/j.chpulm.2... #MedEd #JournalCHEST #Pulmonary Copyright for this content is held by the American College of Chest Physicians. Permission to redistribute is required.