Original case by Brandon Fainstad, MD
Graphics by Yilin Zhang, MD
- Differentiate trapped lung from pleural effusion and collapsed lung.
A 60 year old woman with mucinous NSCLC and a chronic pleural effusion presents with slowly progressive SOB.
CXR following VATS drainage and attempted pleuradesis
Why did the lung not re-expand with appropriate drainage of her pleural effusion?
Trapped lung occurs when an inflammatory effusion (i.e. empyema, rheumatologic disease, malignant effusion and etc.) creates a fibrous rind around the visceral pleura, preventing it from re-expanding. They are often identified following drainage of a pleural effusion and are differentiated from a traumatic pneumothorax because they will be the same shape and size as they were prior to the drainage.
TAKE HOME POINT
- Consider trapped lung with collapsed lung that does not re-expand with appropriate suction