When both air and fluids are present in the pleural space is called hydro-pneumothorax.
Causes:
1. Infection complicating open type of pneumothorax.
2. Latrogenic during aspiration of pleural effusion.
3. Rupture of lung abscess.
4. Rupture of tuberculous focus.
5. Traumatic.
6. Broncho-pleural fistula.
Signs:
1. Above: Findings of pneumonia.
2. Below: Findings of pleural effusion as below
• In the upper part: Resonance increased.
• In the lower part: Stony dull.
• Succussion splash: Positive.
Management: When small may be kept under observation to see if it resolves spontaneously. Otherwise two intercostals tubes have to be put. One for the pneumothorax in the upper part and other for the draining of the pleural effusion in the dependent part.
Reference:
1. Kumar and Clark, clinical Medicine, 7th edition.
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