Tuesday, August 22, 2006

thoracentesis

An elderly man who has recently gone under heart bypass surgery came in with a complaint of difficulty in breathing. CAT scan revealed that his left lung's pleural cavity was filled with fluid all the way up to aortic arch.



Above is the chest x-ray of the lung being filled up with liquid. His liquid was to be drawn out. When tapped, the part of his back that corresponded to his liquid-fillled lung made the dull sound. Thoracentesis was performed to draw out about 1.0 ~ 1.5 L of fluid. The site of insertion of needle was cleaned and numbed. A small needle was first inserted above his rib cage to ensure that the needle doesn't hit the intercostal artery. When small amount of yellow fluid came out, a bigger needle/cathetor was inserted and then the liquid was pulled out until the patient started coughing due to his lung expanding as the fluid leaves the cavity empty. There was a danger of the needle penetrating the lung but the procedure was successful. I didn't see the result of pleural fluid analysis but it should be due to his heart bypass surgery.