Presentation
Patient admitted with renal failure and acute hypoxic respiratory failure. History significant for recurrent pleural effusions despite therapeutic thoracentesis.
Patient Data
Image 1 - Notice the right sided pleural effusion with fluid seeping into the interlobar (minor) fissure as well.
Image 2- Status post thoracentesis (follow up 2 days later). Notice the pleural lines, demonstrating pneumothorax and incomplete expansion of the right upper and middle lobes.
Image 3- In a few days there was re-accumulation of pleural fluid filling up this potential space.
Case Discussion
Pneumothorax ex-vacuo is a phenomenon that occurs when the lung has lost its ability to re-expand, as a result of recurrent or chronic pleural effusions in the setting of thickened visceral pleura.
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