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What is Pleural Effusion?

The thin membranes that line the lungs and the inside of the chest cavity, which help to lubricate and facilitate breathing, are called pleura. In some cases, an excess amount of fluid may develop between the layers of the pleura outside the lungs. This is known as pleural effusion.

Pleural Effusion

Causes of Pleural Effusion

The common causes of pleural effusion include:

  • Pulmonary embolism
  • Lung or breast cancer
  • Infections such as pneumonia or tuberculosis
  • Complications due to an open-heart surgery
  • Congestive heart failure
  • Auto-immune disorders like lupus or rheumatoid arthritis
  • Severe kidney disease

Symptoms of Pleural Effusion

Signs and symptoms of pleural effusion include:

  • Chest pain
  • Dry cough
  • Fever
  • Shortness of breath
  • Difficulty taking deep breaths
  • Persistent hiccups
  • Fatigue with physical activity

Diagnosis of Pleural Effusion

Your doctor will review your medical history and symptoms and a physical examination will be conducted. During the physical examination, your doctor uses a stethoscope to listen to your heart and lungs while you breathe. Diagnostic tests that may be ordered include:

  • Chest X-ray: You may be asked to lie on your side during the x-ray procedure to better visualize the pleural effusion. Generally, air spaces appear black on X-rays, while effusion appears white in colour.
  • CT scan: A CT scanner may be used to obtain a more detailed view of your entire chest.
  • Ultrasound: An ultrasound can recreate an image of the structures inside the body using sound waves and display it on a video screen, helping your doctor identify the presence of fluid between the layers of the pleura.
  • Thoracentesis: Your doctor will take a fluid sample from your chest by inserting a tube called a catheter along with a needle between your ribs into the pleural space. This fluid will be later tested in a lab to confirm the diagnosis. The fluid taken from your pleura space may be examined so as to obtain a proper understanding of the condition.

Treatment for Pleural Effusion

Treatments for pleural effusion include:

  • Medications: If the pleural effusion is not very severe, medications such as antibiotics or diuretics may be enough to treat the condition.
  • Draining fluid: This treatment method involves the use of a chest tube or a long-term catheter inserted into the pleural space through a small incision in the chest wall to drain the pleural effusion.
  • Pleurodesis: In this treatment method, your doctor will drain out the fluid from your chest using a needle or tube and then inject a drug into the space between the layers of the pleura. Usually, the injected drug is a talc mixture, which causes the layers to stick together, preventing future fluid collection.
  • Surgery: Surgical procedures may be used in cases when the effective draining of fluid is not possible. The surgery used includes:
    • Video-assisted thoracoscopic surgery (VATS): This procedure is effective in managing pleural effusion that is difficult to drain or recurs due to malignancy. Sterile talc or an antibiotic may be injected into the space between the layers during the time of surgery to prevent future fluid buildup.
    • Thoracotomy: This procedure involves the surgical removal of all the fibrous tissues and infectious material from the pleura. You may have chest tubes for two days to two weeks after the surgery to completely remove the fluid.


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