Journal Information
Vol. 48. Issue 12.
Pages e43-e45 (December 2024)
Visits
156
Vol. 48. Issue 12.
Pages e43-e45 (December 2024)
Images in Intensive Medicine
Full text access
Nutrithorax: an uncommon differential diagnosis of the plankton sign
Nutritórax: un diagnóstico diferencial poco común del signo del plancton
Visits
156
Isabel Canas-Pérez
Corresponding author
icanasp@saludcastillayleon.es

Corresponding author.
, David Pérez-Torres, Cristina Cuenca-Rubio
Servicio de Medicina Intensiva, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León (SACYL), 47012, Valladolid, Spain
This item has received
Article information
Full Text
Download PDF
Statistics
Figures (3)
Show moreShow less
Additional material (1)
Full Text

A 77-year-old woman was admitted to the hospital for bowel obstruction. A central line was placed in the right subclavian vein to initiate parenteral nutrition in the setting of a non-operative management strategy. On admission day 4, the patient developed acute respiratory failure, requiring ICU admission. Point-of-care pleural ultrasound revealed a complex, non-septated massive right pleural effusion with swirling, punctiform internal echoes (plankton sign) (Fig. 1, Video 1). A chest X-ray prior to drainage insertion confirmed the massive effusion (Fig. 2) and revealed displacement of the tip of the central line, compared to the immediate control after its insertion. A thoracostomy catheter was placed, demonstrating a milky-white output from the pleural space (Fig. 3), with high triglyceride (2503 mg/dL), low cholesterol (<20 mg/dL), and high glucose (682 mg/dL) levels, consistent with nutrithorax. Although uncommon, vascular trauma or direct leakage may cause nutrithorax that may be identified with ultrasound.

Figure 1
(0.2MB).
Figure 2
(0.12MB).
Figure 3
(0.17MB).
Statements and declarations

These images have not been previously published.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethics approval

Informed consent was waived according to local regulations.

Financial support

None.

Appendix A
Supplementary data

The following is Supplementary data to this article:

(0.61MB)

Copyright © 2024. Elsevier España, S.L.U. and SEMICYUC
Download PDF
Idiomas
Medicina Intensiva (English Edition)
Article options
Tools
Supplemental materials
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?