The Absent Sinusoid Sign

Wong, Ada; Patail, Hassan; Ahmad, Sahar

doi:10.1513/annalsats.201810-654cc

Cited by 7 publications

(7 citation statements)

References 5 publications

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“…Certain features have been described that may hint at a non-expandable lung. On m-mode in usual pleural effusion, the lung can be seen making a sinusoidal pattern; this has been noted to be lost in non-expandable lungs, known as the "absent sinusoidal sign" [ 9 ]. Along with the absent sinusoidal sign, other common bedside ultrasound findings are usually pleural thickening, pleural nodularity, and loculated effusion.…”

Section: Discussionmentioning

confidence: 99%

Pneumothorax Ex-vacuo or Trapped Lungs Appearing as Iatrogenic Hydropneumothorax: A Case Report and Review of Non-expandable Lungs (NEL)

Siddiqui¹,

Falak²

2023

Cureus

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Non-expandable lungs are usually diagnosed after a pleural intervention. It can be challenging to differentiate between an iatrogenic pneumothorax and a new diagnosis of non-expandable lungs following a pleural intervention. The correct assessment can save the patient from undergoing the insertion of an unnecessary intercostal chest drain, which often leads to catastrophe. Suspicion and early evaluation remain the keys, particularly in patients with chronic effusion. Often the diagnosis is reached through a combination of history, pleural fluid analysis, and radiological features such as the absence of a straight line in the chest X-ray, which is commonly found in a true hydropneumothorax, along with computed tomographic evidence of chronic effusion with thick pleural rind. Although not routinely performed, pleural manometry can confirm the diagnosis of trapped lungs.We present our case, where a 64-year-old woman with metastatic oesophageal cancer developed a rightsided effusion. The post-procedure chest X-ray following therapeutic aspiration of the pleural fluid gave an impression of iatrogenic hydropneumothorax, which on further careful assessment revealed a rather pneumothorax ex-vacuo along with effusion due to underlying trapped lungs. We present a review of nonexpandable lungs.

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Section: Discussionmentioning

confidence: 99%

Pneumothorax Ex-vacuo or Trapped Lungs Appearing as Iatrogenic Hydropneumothorax: A Case Report and Review of Non-expandable Lungs (NEL)

Siddiqui¹,

Falak²

2023

Cureus

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“…Conversely, identifying NEL prior to definitive intervention would be of benefit as first-line IPC is the optimal choice in these cases. Noninvasive techniques that can forecast its probability include TUS identification of an absent sinusoid sign (a dynamic sonographic M-mode finding indicating motion of atelectatic lung during respiration within pleural fluid) and reduced motion of the atelectatic lung [ 160 – 162 ].…”

Section: Managementmentioning

confidence: 99%

Malignant pleural disease

Piggott,

Hayes,

Greene

et al. 2023

Breathe

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Malignant pleural disease represents a growing healthcare burden. Malignant pleural effusion affects approximately 1 million people globally per year, causes disabling breathlessness and indicates a shortened life expectancy. Timely diagnosis is imperative to relieve symptoms and optimise quality of life, and should give consideration to individual patient factors. This review aims to provide an overview of epidemiology, pathogenesis and suggested diagnostic pathways in malignant pleural disease, to outline management options for malignant pleural effusion and malignant pleural mesothelioma, highlighting the need for a holistic approach, and to discuss potential challenges including non-expandable lung and septated effusions.

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“…The absent “sinusoid sign” ultrasound finding described in Ultrasound Reflections, if validated, provides a valuable noninvasive method to predict patients with a trapped lung (1). At this time, the gold standard for the diagnosis is the use of pleural manometry concurrent with a thoracentesis (2); thus, patients with a trapped lung are subjected to the both the risks inherent to the thoracentesis itself; namely, discomfort, pneumothorax, and hemorrhage, and the risks of pleural drainage in the setting of a trapped lung; namely, pneumothorax ex vacuo and reexpansion pulmonary edema (3, 4).…”

mentioning

confidence: 99%