Hydropneumothorax
Updates to Article Attributes
Body
was changed:
Hydropneumothorax is a term given to the concurrent presence of a pneumothorax as well as a hydrothorax (i.e. air and fluid) in the pleural space.
Pathology
It may arise in various situations which include
- thoracentesis 1,2
- thoracic trauma
- bronchopleural fistula
- oesophagopleural fistula
Radiographic features
Plain radiograph
On an erect chest radiograph, recognition of hydropneumothorax can be rather easy - and is classically shown as an air-fluid level. On the supine radiograph, this may be more challenging where a sharp pleural line is bordered by increased opacity lateral to it within the pleural space may sometimes suggest towards the diagnosis 3,4.
Ultrasound
Sonographic findings include 7;
-
hydro-point sign
-
describes the interface of a pleural line which lacks lung sliding and an anechoic collection bounded inferiorly by the diaphragm
- coexistence of the sonographic signs characteristic of a pneumothorax and a pleural effusion6
- a lung point sign may also be found
-
describes the interface of a pleural line which lacks lung sliding and an anechoic collection bounded inferiorly by the diaphragm
Differential diagnosis
For an air-fluid level on plain film consider
- pyopneumothorax
- haemothorax
- pulmonary abscess
- traumatic pneumatocele
- soft tissue abscess
-</ul><h4>Radiographic features</h4><h5>Plain radiograph</h5><p>On an erect chest radiograph, recognition of hydropneumothorax can be rather easy - and is classically shown as an air-fluid level. On the supine radiograph, this may be more challenging where a sharp pleural line is bordered by increased opacity lateral to it within the pleural space may sometimes suggest towards the diagnosis <sup>3,4</sup>. </p><h4>Differential diagnosis</h4><p>For an air-fluid level on plain film consider</p><ul>- +</ul><h4>Radiographic features</h4><h5>Plain radiograph</h5><p>On an erect chest radiograph, recognition of hydropneumothorax can be rather easy - and is classically shown as an air-fluid level. On the supine radiograph, this may be more challenging where a sharp pleural line is bordered by increased opacity lateral to it within the pleural space may sometimes suggest towards the diagnosis <sup>3,4</sup>. </p><h5>Ultrasound</h5><p>Sonographic findings include <sup>7</sup>;</p><ul><li>
- +<a title="hydro-point sign" href="/articles/hydro-point-sign">hydro-point sign</a><ul>
- +<li>describes the interface of a pleural line which lacks <a title="Pneumothorax (ultrasound)" href="/articles/pneumothorax-ultrasound-1">lung sliding</a> and an anechoic collection bounded inferiorly by the diaphragm<ul><li>coexistence of the sonographic signs characteristic of a pneumothorax and a <a title="Pleural effusion" href="/articles/pleural-effusion">pleural effusion</a> <sup>6</sup>
- +</li></ul>
- +</li>
- +<li>a <a title="Lung point sign" href="/articles/lung-point-sign">lung point sign</a> may also be found</li>
- +</ul>
- +</li></ul><h4>Differential diagnosis</h4><p>For an air-fluid level on plain film consider</p><ul>
References changed:
- 6. Targhetta R, Bourgeois JM, Chavagneux R, Marty-Double C, Balmes P. Ultrasonographic approach to diagnosing hydropneumothorax. (1992) Chest. 101 (4): 931-4. <a href="https://www.ncbi.nlm.nih.gov/pubmed/1555465">Pubmed</a> <span class="ref_v4"></span>
- 7. Volpicelli G, Boero E, Stefanone V, Storti E. Unusual new signs of pneumothorax at lung ultrasound. (2013) Critical ultrasound journal. 5 (1): 10. <a href="https://doi.org/10.1186/2036-7902-5-10">doi:10.1186/2036-7902-5-10</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/24355346">Pubmed</a> <span class="ref_v4"></span>
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