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[Clinical Picture] Re-expansion pulmonary oedema

A 46-year-old man presented to the emergency department with moderate dyspnoea and a 4-day history of cough. His medical history also included alcoholic cirrhosis with portal hypertension and ascites. On admission, a chest x-ray showed complete white-out of the right hemithorax with contralateral mediastinal deviation compatible with a large pleural effusion—presumed to be hepatic hydrothorax (figure). A chest drain was inserted into the right pleural cavity under ultrasound guidance and 2 L of clear fluid were rapidly drained over approximately 2 min.