The n e w e ng l a n d j o u r na l of m e dic i n e

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Hydropneumothorax

A 
47-year-old man with a history of cirrhosis associated with al- Ping-Hsien Chen, M.D.
cohol abuse presented with a 2-day history of shortness of breath. Before this Xi-Zhang Lin, M.D.
symptom developed, he had been treated with repeated thoracentesis of the National Cheng Kung University
right side for cirrhosis-associated hydrothorax. On pulmonary examination, breath Tainan, Taiwan
sounds were absent on the right side, and a succussion splash was audible in the bing_tw@hotmail.com
right upper chest when the patient was gently shaken. Chest radiography showed hy-
dropneumothorax with a collapsed right lung and an adjacent thoracic air–liquid
level, which was probably the result of repeated thoracentesis. The patient was
treated with chest-tube placement and diuretics. An analysis of the pleural effusion
revealed transudative fluid without evidence of infection or cancer. The chest drain
was removed 1 week later, after reexpansion of the lung.
Copyright © 2010 Massachusetts Medical Society.

n engl j med 362;3  nejm.org  january 21, 2010 e9

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