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Images in medicine
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

http://dx.doi.org/10.1136/postgradmedj-2018-136224

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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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    Footnotes

    • Contributors ID: diagnosed the patient and all authors treated the patient. YG: analysed the imaging studies. AS: prepared and submitted the manuscript which was seen and approved by ID and YG.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; internally peer reviewed.