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Trapped Lung After Failed Pleurodesis — SCE Palliative Medicine MCQ

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HardRespiratory SymptomsTrapped Lung After Failed PleurodesisSCE Palliative Medicine

After drainage of a recurrent malignant pleural effusion, the lung remains non-expandable and the patient develops pain with further aspiration. Which definitive strategy is generally most suitable for recurrent breathlessness?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Indwelling pleural catheter with symptom-guided drainage

Pleurodesis requires visceral and parietal pleural apposition, so substantial non-expandable lung makes it less likely to succeed. An indwelling pleural catheter can palliate recurrent breathlessness without requiring full expansion, with drainage limited by symptoms and discomfort. Surgical options are highly selected and repeated forced drainage can cause pain or pressure-related harm.

Reference: British Thoracic Society Clinical Statement on pleural procedures: https://www.brit-thoracic.org.uk/document-library/clinical-statements/pleural-procedures/pleural-procedures-full-supplement/