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Pleural effusion

From Mediwikis
Left sided Pleural Effusion Chest X Ray

Fluid between the 2 pleural layers (more than 300mls gives clinical signs). Normally pleural fluid is secreted by the parietal pleura and reabsorbed by the visceral pleura. Limits lung expansion

4 types

  1. Serous fluid; hydrothorax
  2. Blood; haemothorax
  3. Chyle (lymphatic fluid); Chylothorax
  4. Pus; Pyothorax or empyema

The fluid can be

  1. Transudate; Low protein and due to a failure (heart failure, Liver failure, ect)
  2. Exudate; High protein and due to something extra (infection, neoplasia)

Signs & Symptoms

Asymptomatic, or SOB and pleuritic chest pain

  • decreased expansion
  • stony dull percussion
  • diminished breath sounds
  • tactile vocal frematis and vocal resonance are decreased
  • Bronchial breathing above effusion
  • Can get tracheal deviation away from effusion.

XRAY findings

  • Fluid collects and builds up in the base of the lung, the density is continuous throughout and there may not be a obvious meniscus line

Diagnostic aspiration +/- pleural biopsy


Management

Drainage, pleurodesis