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Updated: Aug 10, 2025
03:22
Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
Published on: November 10, 2023
790
Spontaneous large volume hemothorax managed with a small-bore chest tube
1Department of Medicine, Aga Khan University, Karachi. moiz_salahuddin@hotmail.com.
Summary
This case study shows that conservative management, including aspiration and chest tube drainage, can effectively treat spontaneous hemothorax in patients with metastatic lung cancer, avoiding further transfusions.
Area of Science:
- Pulmonology
- Oncology
- Radiology
Background:
- Metastatic lung cancer can lead to serious complications.
- Spontaneous hemothorax is a rare but critical condition requiring prompt diagnosis and management.
Observation:
- A 67-year-old male with metastatic lung cancer presented with acute respiratory distress and anemia.
- Chest X-ray revealed significant left lung opacification, and bedside ultrasound identified a large pleural effusion with a 'plankton sign' suggestive of blood.
Findings:
- Aspiration of the pleural effusion yielded frank blood.
- A small-bore chest tube (SBCT) was inserted, draining 3200 mL of blood.
- The patient's condition improved with complete pleural space clearance and cessation of blood transfusions.
Implications:
- This case suggests that conservative management, including ultrasound-guided aspiration and SBCT, can be a viable option for spontaneous hemothorax in metastatic lung cancer patients.
- Early diagnosis using bedside ultrasound is crucial for effective intervention.
- This approach may help avoid more invasive procedures and reduce the need for blood product transfusions.
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