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Updated: Feb 24, 2026

Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
Published on: November 10, 2023
A 54-Year-Old Man With Anasarca, Dyspnea, and Recurrent Bilateral Pleural Effusions
Pradnya D Patil1, Yvette M Cua2, Carol Farver3
1Department of Hospital Medicine, Medicine Institute, Cleveland Clinic, Cleveland, OH.
Case Presentation:
A 54-year-old African-American man presented with 2 years of progressively worsening dyspnea and anasarca. Over the past 6 months he gained 30 lbs with worsening lower extremity, abdominal wall, and scrotal edema. A recent workup for cardiac, renal, and liver disease, including two-dimensional echocardiogram, liver and renal function tests, and abdominal ultrasound, was unremarkable. He reported a 15-pack year history of smoking and quit 3 years ago. Chest radiograph at that time revealed bilateral pleural effusions that were both reportedly milky in appearance when drained by thoracenteses.
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