Case of massive pleural effusion during and after oophorectomy

A 26-year-old woman with ovarian tumor underwent bilateral oophorectomy. Pre-operative examination showed massive ascites, obvious edema of the lower extremities and absence of pleural effusion. Immedi- ately after removal of massive ascites during the operation, sudden deterioration of SpO2 appeared. We treated it with addition of PEEP and furosemido i.v., and SpO2 improved. After the operation we recognized left sided massive pleural effusion on the chest X-ray picture, and we drained it. However, the next day we recognized right side massive pleural effusion. We suspect that the fluid pooled in the lower extremities shifted to produce pleural effusion for some reason or other.