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Updated: Jan 26, 2026

Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
Published on: November 10, 2023
A 73-Year-Old Man With Progressive Whole Body Subcutaneous Gas After Pleural Catheter Removal
Thomas W DeCato1, Rebecca E Burk2, Mustafa Mir-Kasimov3
1Department of Medical Education & Clinical Sciences, Washington State University Elson S. Floyd College of Medicine, Spokane, WA; Pulmonary Medicine, Providence Medical Group, Spokane, WA.
Case Presentation:
A 73-year-old man presented to the ED of an outside hospital with asymptomatic chest wall swelling 10 h after discharge from our hospital. Four days earlier, he had presented to our hospital with increased dyspnea, cough, and sputum production. His history was notable for severe COPD with bullous emphysema. Chest imaging demonstrated bilateral opacities and a collection of gas and liquid in the major fissure of the left lung. A catheter was placed into the collection of gas and liquid under imaging guidance. After 4 days, the catheter was removed without event and the patient was discharged from the hospital with an extended course of antibiotics. Imaging performed in the ED revealed gas in the tissues of the chest wall and no evidence of a pneumothorax. He was transported back to our hospital by helicopter.
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