Журнал клинических случаев

Continuous Drainage of a Pleural Effusion with a Pigtail Catheter Secondary to Ovarian Hyperstimulation Syndrome: A Case Report with Literature Review

Abstract

Harpreet K Brar, Roohi Jeelani, Jashoman Banerjee, Michael Diamond, Awoniyi O Awonuga, Manvinder Singh and Sana N Khan

Background: Ovarian Hyperstimulation Syndrome (OHSS) is an iatrogenic complication that may occur in hormonally induced ovarian stimulation cycles. Generally, the symptoms are self-limited and resolve spontaneously. Occasionally OHSS can become life-threatening secondary to complications such as venous thromboembolic events, electrolyte imbalance, organ dysfunction and massive third spacing. Pleural effusion, or fluid collection within the pleural cavity surrounding the lungs is one such negative consequence. Our objective was to describe an unusual case requiring the need for continuous drainage of a pleural effusion in a patient suffering from OHSS with minimal ascites. Case presentation: We present a case of a patient undergoing treatment for infertility that presented to the ED with complaints of shortness of breath and abdominal pain. Reoccurence of pleural effusion on the left side prompted one-time thoracentesis. Reoccurrence of her left lung pleural effusion prompted a one-time left thoracocentesis, which was complicated by a pneumothorax. Eventually, the patient did well and went on to have an uncomplicated delivery. Conclusion: Although pleural effusions with the absence of clinically significant ascites secondary to OHSS are not readily diagnosed they carry significant morbidity. In this report, early diagnosis and intervention with the use of a continuous pigtail drain resulted in an excellent patient outcome.