Pleural Effusion

Pleural Effusion sometimes referred to as "water in the lungs," is the build-up of excess fluid between the layers of the pleura outside the lungs. The pleura are thin membranes that line the lungs and the inside of the chest cavity and act to lubricate and facilitate breathing. Normally, a small amount of fluid is present in the pleura.

Signs and Symptoms

• Chest pain
• Shortness of breath
• Fever
• Dry, nonproductive cough
• Dyspnea (shortness of breath, or difficult, labored breathing)

Causes of Pleural Effusion

• Tuberculosis
• Pneumonia
• Heart failure
• Pulmonary embolism
• Cirrhosis
• Post open heart surgery
• Cancer
• Kidney disease
• Inflammatory disease
• Autoimmune disease
• Bleeding (due to chest trauma)
• Rare chest and abdominal infections
• Asbestos pleural effusion (due to exposure to asbestos)
• Meig’s syndrome (due to a benign ovarian tumor)
• Ovarian hyperstimulation syndrome

Diagnosis and Tests

The tests most commonly used to diagnose and evaluate pleural effusion include:

• Chest x-ray
• Computed tomography (CT) scan of the chest
• Ultrasound of The chest
• Thoracentesis (a needle is inserted between the ribs to remove a biopsy, or sample of fluid)
• Pleural fluid analysis (an examination of the fluid removed from the pleura space)

Treatment

Dr. Indu Bubna –Chest Specialist in Mumbai will suggest the best treatment plan

• Thoracentesis: draining fluid with a needle or a chest tube
• Decortication: Opening the chest to remove the diseased pleura
• Video-Assisted Thoracoscopic Surgery (VATS): Treatment for mechanical problems (fluid, air, or blood) focuses mainly on removing the fluid, air, or blood A minimally invasive alternative to open-chest surgery that involves less pain and recovery time. After you receive a sedative, your surgeon will make tiny incisions in your chest and then insert a fiber-optic camera called a thoracoscope. Images from the thoracoscope will give the pulmonologist important information that will help guide the appropriate treatment.
• Abrading the pleural surface to achieve adherence of the lung to the chest wall may be required for recurrent pneumothorax.
• Extrapleural pneumonectomy: In some cases of malignancy (mesothelioma), removal of all of the pleura, as well as the underlying lung, may be indicated.

Types Of Pleural Diseases

Pleural effusion: This is excess fluid in the pleural cavity. This is one of the most common problems associated with the pleura. The most common cause is congestive heart failure. Other causes include lung cancer, pneumonia, tuberculosis, liver disease, pulmonary embolism. Pleural effusion generally causes no symptoms and, by itself, is not serious.

Hemothorax: is a buildup of blood in the pleural cavity. Chest trauma due to the accident is the most common cause, but cancer of the lung or pleura or open-heart surgery can also cause a hemothorax.

Empyema: The accumulation of pus in the pleural cavity. This is a type of pleural effusion that is usually associated with pneumonia. The symptoms are those of pneumonia (cough, fever) in addition to shortness of breath and impaired breathing.

Pleural tumors: Pleural tumors are cancerous tissues in the pleural cavity. Usually, pleural tumors are cancers that have spread from other areas of the body. Symptoms: Shortness of breath, chest pain, cough, unexpected weight loss

Pleurisy is pain associated with inflammation of the pleural cavity. The most common cause is a viral infection, such as influenza. Other causes include bacterial and fungal infections, lung cancer, other diseases such as rheumatoid arthritis and mesothelioma, and reaction to certain medications. Symptoms of pleurisy may include a sharp pain when breathing, shortness of breath, a cough, fever and chills, rapid breathing, unexplained weight loss, and sore throat followed by joint swelling and soreness.

Pneumothorax is a buildup of air or gas in the pleural cavity around the lung that causes the lung to collapse. Chronic obstructive pulmonary disease, tuberculosis, and trauma are the most common causes. Symptoms: Shortness of breath, rapid breathing, chest pain when taking a deep breath (pleurisy), cyanosis (bluish discoloration of the skin), respiratory distress if large