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Case Report
Massive surgical emphysema due to coughing at local anesthetic thoracoscopy
1 Department of Respiratory Medicine, Northumbria Healthcare NHS Trust, Northumbria Way, Cramlington NE23 6NZ, UK
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Avinash Aujayeb
Department of Respiratory Medicine, Northumbria Healthcare NHS Trust, Northumbria Way, Cramlington NE23 6NZ,
UK
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Article ID: 101537Z01AA2026
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How to cite this article
Aujayeb A. Massive surgical emphysema due to coughing at local anesthetic thoracoscopy. Int J Case Rep Images 2026;17(1):42–46.ABSTRACT
Local anesthetic thoracoscopy (LAT) is a popular tri-modality approach used in the investigation and management of unexplained exudative pleural effusions. No international guidelines exist, and practice is widely variable. We describe a case of a patient with an exudative pleural effusion whose radiology was concerning for malignancy. Severe coughing during LAT caused an air leak, massive surgical emphysema (SE) which required a large bore chest drain and a small bore subcutaneous drain. Surgical emphysema eventually settled, and the patient was discharged to start systemic anti-cancer therapy.
Keywords: Chest drain, Local anesthetic thoracoscopy, Medical thoracoscopy, Surgical emphysema
SUPPORTING INFORMATION
Author Contributions
Avinash Aujayeb - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthor declares no conflict of interest.
Copyright© 2026 Avinash Aujayeb. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
