Massive pleural effusion as the presenting feature of a subarachnoid-pleural fistula.

A 14-year-old boy presented with a large symptomatic transudative pleural effusion 4 months after spinal surgery for kyphoscoliosis. Computed tomography myelography confirmed a subarachnoid-pleural fistula (SPF) with a pseudo-meningocele communicating with the left pleural space. A review of the literature indicates this to be a rare finding. The possibility of SPF should be entertained in patients who present with a pleural effusion following transthoracic spinal surgeries.

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