Chest plain radiograph after thoracoscopic plication. (A) Right massive and loculated pleural effusions were seen. (B) Massive pleural effusion and dislocation of cystoperitoneal shunt were found under thoracoscope examination. (C) The meningocele was reduced to a lump of soft tissue at the root with multiple plication. (D) Postoperatively chest radiograph at 2 months showed a marked improvement in lung volume.