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Right-Sided Pleural Effusion in a Critically Ill Stroke Patient
Alexander Bautista1, Michael Heine1, Victor van Berkel1
1University of Louisville, Louisville, KY, USA.
Journal of Investigative Medicine High Impact Case Reports
|October 2, 2015
Summary
A stroke patient developed respiratory issues and a pleural effusion. Later, an esophageal perforation was found, revealing non-small cell lung cancer at the perforation site.
Area of Science:
- Medicine
- Critical Care
- Pulmonology
Background:
- Pleural effusions are common in critically ill patients.
- Middle cerebral artery stroke can lead to respiratory complications.
- Diagnostic challenges exist in critically ill patients with persistent radiographic opacities.
Purpose of the Study:
- To report a rare case of esophageal perforation secondary to non-small cell carcinoma in a stroke patient.
- To highlight the diagnostic pathway from respiratory distress to esophageal perforation and malignancy.
Main Methods:
- Case report of a patient with left middle cerebral artery stroke.
- Management of respiratory distress with intubation and mechanical ventilation.
- Diagnostic workup including chest radiography, pleural fluid drainage, and fluoroscopic swallow study.
Main Results:
- Patient developed a right-sided pleural effusion requiring drainage.
- Esophageal perforation was diagnosed via fluoroscopic examination.
- Non-small cell carcinoma was identified at the site of esophageal perforation.
Conclusions:
- Esophageal perforation can be a rare complication in critically ill patients.
- Persistent radiographic findings in critically ill patients warrant thorough investigation.
- Malignancy should be considered in cases of spontaneous or iatrogenic esophageal perforation.
Keywords:
critical careesophageal perforationnon–small cell lung carcinomapleural effusiontransesophageal echocardiographyMore Related Videos
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