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Hydropneumothorax

From Wikipedia, the free encyclopedia
Hydropneumothorax
A hydropneumothorax with a white arrow pointing to the lung's pleura
SpecialtyEmergency medicine

Hydropneumothorax is defined as the presence of both air and fluid within the pleural space.[1] An upright chest x-ray will show air fluid levels. The horizontal fluid level is usually well defined and extends across the whole length of one of the hemithorax.

Signs and symptoms

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This can be remembered by the 4 'S': straight line dullness, shifting dullness, splash, sound of coin.

Causes

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  • Iatrogenic: Introduction of air during pleural fluid aspiration in effusion
  • Presence of a gas-forming organism
  • Thoracic trauma

Diagnosis

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Diagnosis can be via CXR. CT is better for outlining borders of air-fluid levels, however, CT has a greater radiation exposure.

Ultrasound imaging has also proven to be a useful tool for hydropneumothorax diagnoses by looking for the absence of the characteristic "curtain sign" usually seen in ultrasound images at the base of healthy lungs.[2]

Treatment

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Treatment includes intercostal drainage (ICD) of fluid and air and treatment of underlying conditions.

References

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  1. ^ Clarke, Christopher; Dux, Anthony (2017). Chest X-rays for Medical Students. John Wiley & Sons. p. 82. ISBN 9781119426721. Retrieved 6 November 2017.
  2. ^ Targhetta, Rémi; Bourgeois, Jean-Marie; Chavagneux, Roseline; Marty-Double, Christiane; Balmes, Pierre (1992-04-01). "Ultrasonographic Approach to Diagnosing Hydropneumothorax". Chest. 101 (4): 931–934. doi:10.1378/chest.101.4.931. ISSN 0012-3692.
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