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Pseudohemothorax induced by residual contrast medium mimicking aortic dissection rupture
Kazuya Okamura1, Rika Yoshida1, Takeshi Yoshizako1
1Department of Radiology, Shimane University, Faculty of Medicine, Izumo, Shimane, Japan.
Acta Radiologica Open
|April 28, 2022
Summary
High-concentration pleural effusion in end-stage renal disease patients may be caused by residual contrast medium, not hemothorax. This distinction is crucial for avoiding unnecessary invasive procedures.
Area of Science:
- Nephrology
- Radiology
- Thoracic Surgery
Background:
- Hemothorax is a critical condition requiring prompt diagnosis and etiological identification.
- Distinguishing hemothorax from other causes of pleural effusion is essential for appropriate patient management.
Observation:
- A case of a 74-year-old male with end-stage renal disease presented with high-concentration pleural effusion.
- The effusion was attributed to residual contrast medium following contrast-enhanced computed tomography (CECT).
- This presentation mimicked hemothorax secondary to aortic dissection and rupture.
Findings:
- In end-stage renal disease patients, sequential CECT and non-contrast CT can lead to high-concentration pleural effusions from retained contrast.
- This finding necessitates careful differentiation from emergent conditions like aortic dissection or aneurysm rupture.
Implications:
- Accurate differentiation prevents misdiagnosis of hemothorax, avoiding unnecessary invasive procedures such as thoracentesis.
- Radiological protocols should consider the potential for contrast-induced effusions in renal disease patients.
- This case highlights the importance of integrating clinical context with imaging findings for urgent thoracic conditions.
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