Elderly Male With Dyspnea

An 81-year-old man with a history of gastric malignancy developed progressive dysphagia. He became breathless shortly after swallowing barium as an outpatient and was subsequently referred to our emergency department 2 hours later. His blood pressure was 120/90 mm Hg, pulse rate was 140 beats/min, respiratory rate was 36 breaths/min, and SpO2 was 69%. Furthermore, lung ultrasound demonstrated a shred or fractal sign at the posterolateral alveolar and/or pleural syndrome points bilaterally (Figure 1, Video 1).