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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis

Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis

Published on: February 10, 2023

Bilateral lower extremity swelling: black pearl.

Clinton C Smithson¹, Jared C Ham¹, Andrew L Juergens¹

¹Baylor Scott & White Health, MS-11-AG062, 2401 South 31st Street, Temple, TX, 76502, USA.

The American Journal of Emergency Medicine

|May 25, 2015

Summary

A rare case of tension pneumothorax after thoracentesis caused leg swelling. Prompt catheter insertion resolved the condition, highlighting the need for vigilance in patients with recent pleural procedures.

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Area of Science:

Emergency Medicine
Pulmonology
Radiology

Background:

Iatrogenic pneumothorax from thoracentesis is uncommon.
Tension physiology developing from iatrogenic pneumothorax is rare.
Pleural effusions due to lung cancer can necessitate thoracentesis.

Observation:

An elderly female presented with bilateral leg swelling post-thoracentesis.
The patient was hemodynamically stable with chronic obstructive pulmonary disease and diminished lung sounds.
Radiologic diagnosis revealed a subacute tension pneumothorax.

Findings:

A 10F intrapleural catheter was inserted in the second intercostal space.
The procedure successfully resolved the tension pneumothorax and leg swelling.
The patient was discharged with no recurrence of pneumothorax.

Implications:

This case highlights a rare presentation of inferior vena cava syndrome secondary to tension pneumothorax.
A high index of suspicion for acute chest pathology is crucial in patients with recent pleural interventions.
Early recognition and intervention are key for managing iatrogenic pneumothorax complications.