Always Worth Another Look? Thoracic Ultrasonography before, during, and after Pleural Intervention

Our plain-English summary of Always Worth Another Look? Thoracic Ultrasonography before, during, and after Pleural Intervention, by J.P. Corcoran, I. Psallidas, C.L. Ross, et al (Annals of the American Thoracic Society, 2016).

The study

• Authors: J.P. Corcoran, I. Psallidas, C.L. Ross, R.J. Hallifax, N.M. Rahman
• Journal: Annals of the American Thoracic Society
• Published: 2016;13(1):118-21
• Type of article: Case report
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A 73-year-old man with a history of occupational asbestos exposure presented with right-sided pleural thickening and effusion. Point-of-care ultrasound assessment before intervention identified the presence of a tethered lung, leading to a change in the plan for obtaining biopsies of the pleural space. Postintervention ultrasound imaging provided further diagnostic information, allowing the responsible clinicians to institute prompt emergency care with a successful outcome.

PubMed has no abstract for this study. This is the authors' abstract, copied from the article.

In plain English

This article is a case report from the Oxford Centre for Respiratory Medicine in the United Kingdom about one patient. A 73-year-old man, a retired construction worker with a history of occupational asbestos exposure who had never smoked, was evaluated for a two-month cough. His chest X-ray showed right-sided pleural thickening and fluid (effusion), along with plaques consistent with previous asbestos exposure. CT scanning showed irregular pleural thickening and a large effusion. Mesothelioma was believed most likely, and the team planned thoracoscopy. Ultrasound before the procedure suggested the lung was tethered by adhesions, so they instead took ultrasound-guided needle biopsies of a chest wall mass and the pleura, and drained fluid for testing. A routine ultrasound afterward showed active bleeding into the pleural space. The bleeding stopped after 10 minutes with conservative medical measures alone, including firm pressure applied with the ultrasound probe. The man was discharged 6 hours after the procedure. The biopsies confirmed epithelioid mesothelioma, and he started chemotherapy. The authors concluded that routine ultrasound after any pleural intervention should be encouraged as a quick way to identify serious complications early.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One 73-year-old man, a never-smoker and retired construction worker, treated at the Oxford Centre for Respiratory Medicine, United Kingdom
• Exposure: Occupational asbestos exposure as a construction worker. No fiber type or dose is given. Plaques on the chest X-ray were consistent with previous asbestos exposure.
• Main results:
  • Ultrasound before the procedure showed no lung sliding, indicating adhesions and a tethered lung. The planned thoracoscopy was replaced by needle biopsies and diagnostic thoracentesis.
  • Routine ultrasound after the procedure showed active bleeding into the pleural space from the biopsy site.
  • The bleeding stopped after 10 minutes with conservative medical measures alone. The patient was discharged 6 hours after the procedure.
  • The biopsies confirmed epithelioid mesothelioma, and the patient started systemic chemotherapy.
• The authors' conclusion: The authors concluded that routine ultrasound after any pleural intervention should be encouraged as a quick and effective way to identify potentially serious complications, such as bleeding into the pleural space or collapsed lung, at an early stage.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma, Pleural plaques and thickening.

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Pleural Thickening, Ultrasound.

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