One view, multiple effusions
We previously went over examples of pleural effusion and ascites visualized from the subcostal/subxiphoid window. Here is another nice clip demonstrating right and left pleural effusions, pericardial effusion and ascites obtained from a patient with advanced chronic kidney disease. Labeled images included.
To see these effusions, use a higher depth and angle the beam into the chest such that the probe is almost parallel to the abdomen. You should see ascites if present along with pericardial effusion and then fan the probe slightly inferiorly to visualize the pleural effusion(s). Vertebral body/spine separates right and left pleural effusions.
Below image shows pericardial effusion visualized from the subxiphoid IVC view in the same patient. Ideally, isolated IVC examination (without heart and lung POCUS) should not be performed. But for whatever reason, you just want to look at the IVC and it appears plethoric, pay attention to the heart area (superior) and you might find a clue to pericardial effusion.
Leave a Reply