2007 Volume 21 Issue 4 Pages 565-570
A 56-year-old man was referred to us for the control of refractory pleural effusion. He had a 6-year history of bronchiolitis obliterans with organizing pneumonia (BOOP) and had been under steroid therapy for 4 years. Left pleural effusion together with a yellowish discoloration and thickening of the finger and toe nails had been noticed three years ago. Furthermore, bilateral pleural effusion had been seen one year later. Finally, he was diagnosed as "yellow-nail syndrome" one year ago. Despite the fact that pleural tap had occasionally been performed, dyspnea on exertion gradually worsened because of the rapid increase of pleural effusion. In January, 2006, a right pleuroperitoneal shunt assisted with thoracoscopy was placed under local anesthesia. Thoracoscopic assisted pleuro-peritoneal shunt placement procedure was useful for confirmation of the best region for insertion of the catheter, prospect of the drainage and diagnosis by exclusion of other diseases.
