Left side Hydropneumothorax

65 year male with shortness of breath Chief Complaints C/O Shortness of breath since last 1 month. Progressive from NYHA 2 to 4. C/O Cough most of the times non-productive for last 2 months. C/O fever intermittent since last 1 month Weight loss of nearly 10 kgs in 2 months. History Smoker otherwise no comorbidities. Vitals Saturation 80% on air Heart Rate :- 120/min Temp 99.6f BP 90/60 Physical Examination Respiratory examination revealed Absent Air entry on left side Investigations ESR 80 CRP 69 Mild Leukocytosis Creatinine 2.4 HIV negative Sputum AFB n C&S negative Sputum Cytology revealed Atypical cells clusters highly suggestive of malignancy. Diagnosis PLAIN CT THORAX confirmed left sided Hydropneumothorax. Contrast was avoided due to altered renal function. Repeat scan has been planned after ICD insertion. Management ICD inserted on left side. Clinically patient has stabilised vitally. With FiO2 32% patient is maintaining saturation around 94-95%. Antibiotics, IV fluids n supportive therapy is ongoing. Further management has been planned as per follow up CECT with ICD in situ to confirm malignancy n manage accordingly.

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May consider thoracoscopic repair of underlying etiology of air leak lesion. Mediastinal pleural densities noted. Plz update the case sir.

Thank you doctor
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Lt hydropnumothorax A mass seen in upper mid zone paracardiac region Malignancy Ad CT guided Biopsy Surgery + chemotherapy + Radiotherapy

Anti Tubercular drainge histopathology

Good approach. If malignancy negative tuberculosis must be ruled out.

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