Left-Sided Pleural Effusion as a Complication Following Splenic Embolisation: A Case Report and Literature Review

Most pleural effusions arise due to intrathoracic aetiologies. Left-sided pleural effusion can occur as a complication of splenic artery embolisation (SAE). Nowadays, it is standard practice to perform SAE as a nonoperative management for splenic injury in haemodynamically stable patients. Although it is far less invasive compared to surgical splenectomy, the procedure is associated with possible complications ranging from splenic atrophy and splenic infarction to pleural effusion, fever, and coil migrations. Mild to moderate pleural effusion can be managed conservatively with watchful monitoring, whereas refractory and symptomatic effusions would require repeated thoracocentesis or intercostal chest drain (ICD) insertion. We report a case of a 59-year-old female patient presenting with shortness of breath, associated with pyrexia and raised inflammatory markers. She had undergone a proximal splenic artery embolisation (PSAE) for spontaneous splenic rupture one month prior to her current presentation. Computed tomography (CT) imaging revealed a large left-sided pleural effusion, which caused a contralateral mediastinal shift. Additionally, there was evidence of a splenic infarct post-embolisation and an associated peri-splenic collection. She was managed with an ICD insertion, which was removed after six days, and she was discharged home safely, with a residual loculated pleural effusion. A follow-up chest X-ray at six weeks showed that the remaining effusion had resolved completely without any further complications. Our case highlights the importance of recognising extrapulmonary causes of left-sided pleural effusions, especially in patients who have undergone SAE.