A complex pleural effusion often contains internal septations or fibrin strands, distinguishing it from simple anechoic effusion. These septations suggest exudative processes such as infection, malignancy, or hemothorax.
According to Rumack’s Diagnostic Ultrasound:
“Complex pleural effusions demonstrate internal septations or loculations, often related to infection or malignancy.”
[Reference:, Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017., AIUM Practice Parameter for Thoracic Ultrasound, 2020., —]
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