Fig. 2From: Single-trocar thoracoscopic pericardio-pleural fenestration under local anesthesia for malignant pleural effusion: a case reportThoracoscopic findings. a Thoracoscopic examination reveals many pleural nodules and severely distended pericardium with pericardial effusion. b A tiny pericardial window, about 5 mm in diameter, was created using biopsy forceps (circle). c Bloody pericardial effusion spurts through the pericardial fenestration to the right thoracic cavityBack to article page