Rapidly filling pleural effusion due to a subarachnoid-pleural fistula.
Only five cases of subarachnoid-pleural fistula in children have been reported previously. All had a history of trauma and associated neurologic deficit which gave clue to the diagnosis. The authors present a child who presented with a massive, rapidly filling, clear pleural effusion in whom there was no neurologic deficit. The history of an automobile accident in the past had almost been forgotten. A subarachnoid-pleural fistula was discovered on exploratory thoracotomy. The entity should be thought of, and actively investigated, in a child with a history of trauma and a pleural effusion of obscure etiology, even if there is no associated neurologic deficit.
D000063:Accidents, Traffic; D002675:Child, Preschool; D005402:Fistula / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D050723:Fractures, Bone / Q000150:complications; D006801:Humans; D008297:Male; D010995:Pleural Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D010996:Pleural Effusion / Q000175:diagnosis / Q000209:etiology*; D012008:Recurrence; D013346:Subarachnoid Space; D013904:Thoracic Vertebrae / Q000293:injuries