Wednesday, March 2, 2011

Case: 72 year old male presented after midnight when ancillary services (ultrasound or CT scan) are not available. Initial diagnosis is pneumonia with pleural effusion. What may help you in deciding "to tap or not to tap" (thoracentesis) the patient?



Answer: If there is a confusion about 'size of' pleural effusion, obtain lateral decubitus film. Measure the width of the layering pleural fluid. If the width of the fluid is less than 10 mm, the effusion can be managed medically or thoracentesis may be deferred. And if the effusion is wider than 10 mm, thoracentesis is recommended.

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