title: Subarachnoid pleural fistula due to penetrating trauma: case report and review of the literature.
abstract: We describe a case of a 30-year-old man who developed a recurrent pleural effusion after sustaining a gunshot wound to the left side of his chest with subsequent complete paralysis at the T2 level. Subarachnoid-pleural fistulas have rarely been reported as complications of penetrating and blunt trauma, thoracic surgery, as well as spinal surgery. Concomitant injuries may overshadow or complicate the diagnosis of subarachnoid-pleural fistulas. The diagnosis should be considered in any patient with a pleural effusion that is associated with severe neurologic injury, as the fistula rarely heals without surgical intervention and may lead to CNS infection or pneumocephalus.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Allergy and Clinical Immunology, Medical University of South Carolina, 96 Jonathan LucasStreet, Suite 812, PO Box 250623, Charleston, SC 29425, USA.
authors.forename: Christian
authors.initials: C
authors.lastname: Lloyd
authors.forename: Steven A
authors.initials: SA
authors.lastname: Sahn
mesh_terms: D000328:Adult; D005402:Fistula / Q000209:etiology*; D006801:Humans; D008297:Male; D010995:Pleural Diseases / Q000209:etiology*; D010996:Pleural Effusion / Q000209:etiology; D012008:Recurrence; D013346:Subarachnoid Space; D013898:Thoracic Injuries / Q000150:complications*; D014948:Wounds, Gunshot / Q000150:complications*