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Postpartum shoulder pain and shortness of breath
  1. Ina Dubin1,
  2. Yair Glick2,
  3. Amichai Schattner1,3
  1. 1 Department of Medicine, Laniado Hospital, Sanz Medical Centre, Netanya, Israel
  2. 2 Department of Imaging, Laniado Hospital, Sanz Medical Centre, Netanya, Israel
  3. 3 The Faculty of Medicine, Hebrew University Hadassah Medical School, Jerusalem, Israel
  1. Correspondence to Professor Amichai Schattner, Hebrew University and Hadassah Medical School, Jerusalem 91000, Israel; amischatt{at}gmail.com

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A 29-year-old woman developed increasing right (Rt.) shoulder/chest pain and dyspnoea 16 hours after delivering a healthy baby. Neurofibromatosis type 1 (NF-1) had been diagnosed in childhood by cafe-au-lait macules, neurofibromas and a positive family history.

She appeared acutely ill with tachycardia (120/min), tachyponea (20/min) and hypoxaemia (88% oxygen saturation). Breath sounds were barely audible over the Rt. hemithorax which was dull on percussion. ECG showed sinus tachycardia. Chest X-ray revealed large Rt. pleural effusion (figure 1). Laboratory tests were non-contributory except for serum Na 133 mEq/L due to the syndrome of inappropriate antidiuretic hormone secretion. CT angiography revealed massive Rt. haemothorax and demonstrated active …

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