A case of cirrhosis-associated hydropneumothorax: NEJM case
A 47-year-old man with a history of cirrhosis associated with alcohol abuse presented with a 2-day history of shortness of breath. Before this symptom developed, he had been treated with repeated thoracentesis of the right side for cirrhosis-associated hydrothorax.

On pulmonary examination, breath sounds were absent on the right side, and a succussion splash was audible in the right upper chest when the patient was gently shaken. Chest radiography showed hydropneumothorax with a collapsed right lung and an adjacent thoracic air–liquid level, which was probably the result of repeated thoracentesis.

The patient was treated with chest-tube placement and diuretics. An analysis of the pleural effusion revealed transudative fluid without evidence of infection or cancer. The chest drain was removed 1 week later, after reexpansion of the lung.

Source: https://www.nejm.org/doi/full/10.1056/NEJMicm0810434
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