Free Fluid Below the Diaphragm

This cine demonstrates the left PLAPS (Posterolateral Alveolar and/or Pleural Syndrome) view, with the spleen identified inferior to the diaphragm and the left lung visualised above it

A large anechoic (black) fluid collection is seen inferior to the diaphragm, surrounding the spleen, consistent with free intraperitoneal ascites

The fluid appears simple, without obvious septations or internal echogenic debris

The diaphragm is clearly visualised as a bright curvilinear structure, separating the abdominal ascites from the thoracic cavity

No pleural effusion is identified in this clip, as the fluid is confined below the diaphragm

This view highlights the importance of diaphragm identification when distinguishing ascites from pleural fluid during lung ultrasound examination.