What are the possible complications of diagnostic thoracentesis in the workup for pleural effusion (fluid on the lungs)?

Updated: Dec 28, 2018
  • Author: Kamran Boka, MD, MS; Chief Editor: Guy W Soo Hoo, MD, MPH  more...
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Complications of diagnostic thoracentesis include pain at the puncture site, cutaneous or internal bleeding from laceration of an intercostal artery or spleen/liver puncture, pneumothorax, empyema, reexpansion pulmonary edema, malignant seeding of the thoracentesis tract, and adverse reactions to anesthetics used in the procedure. Pneumothorax complicates approximately 6% of thoracenteses but requires treatment with a chest tube drainage of the pleural space in less than 2% of cases. [30] The use of needles larger than 20 gauge increases the risk of a pneumothorax complicating the thoracentesis. In addition, significant chronic obstructive or fibrotic lung disease increases the risk of a symptomatic pneumothorax complicating the thoracentesis.

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