Hemothorax after Thoracentesis

A 65-year-old woman with atherosclerotic cardiovascular disease and renal failure was hospitalized for acute respiratory failure and bilateral pleural effusions. To rule out empyema, thoracentesis was performed. Hemothorax developed shortly after the procedure. A 65-year-old woman with atherosclerotic cardiovascular disease and renal failure was hospitalized for acute respiratory failure and bilateral pleural effusions associated with pneumonia (Panel A). To rule out the presence of empyema, a diagnostic, ultrasonography-guided thoracentesis was performed in the left lung in the 9th and 10th intercostal spaces. The initial fluid that was extracted had a brown discoloration but was transudative and was thought to be associated with the patient’s cardiorenal disease. Unfortunately, hemothorax developed shortly after the procedure (Panel B). Computed tomography and angiography of the chest revealed tortuous intercostal arteries, which had potentially contributed to iatrogenic arterial . . .