Tension pleural effusion. A delayed complication of pneumothorax therapy in tuberculosis.

Three cases of delayed development of pleural effusion under tension, 20 to 30 years after therapeutic pneumothorax, are described. A sudden increase in dyspnea and the radiographic findings of increasing opacity, a change from hypovolemia to hypervolemia of the hemithorax, and mediastinal shift should alert one to this delayed complication. Careful thoracentesis to decompress intrapleural tension effusion can relieve the dyspnea and improve hypoxemia. The potential risks of creating excessive negative intrapleural pressure are presented.