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Haemothorax — SCE Respiratory MCQ

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HardPleural DiseaseHaemothoraxSCE Respiratory

A 58-year-old woman becomes hypotensive 30 minutes after ultrasound-guided pleural biopsy. She has pleuritic pain and a rapidly enlarging pleural opacity on chest radiograph. Haemoglobin has fallen from 128 g/L to 92 g/L. What is the most likely diagnosis?

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Correct answer: A — Iatrogenic haemothorax

Acute pleural opacity with haemodynamic compromise and a haemoglobin fall after pleural biopsy is most consistent with iatrogenic haemothorax. Vasovagal syncope would not produce a new pleural opacity or anaemia. Re-expansion pulmonary oedema causes parenchymal infiltrates rather than rapid pleural blood accumulation.

Reference: BTS Clinical Statement on Pleural Procedures 2023