Pleural Effusion

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Pleural Effusion

Respiratory MedicineCardio Thoracic Surgery

Pleural Effusion is an abnormal fluid accumulation in the pleural cavity, classified as a pleural disease. Under normal circumstances, the pleural cavity contains only a tiny amount of fluid (10-20 mL) to facilitate smooth pleural movement. When the fluid volume increases, it can compress lung tissue, leading to symptoms such as shortness of breath, chest pain, and other respiratory issues. Prompt diagnosis and treatment are essential.

Diagnosis

Diagnosis methods for Pleural Diseases:

Chest X-ray	X-rays can detect abnormalities in the lungs, and doctors will observe the location of any shadows in the lungs.
Computerized Tomography (CT) Scan	This technique uses X-ray radiation and contrast imaging to depict the condition of the lungs. Computer analysis of the images assists doctors in diagnosing lung conditions.

Treatment

Pleural drainage is a crucial part of managing these conditions. It involves inserting a small tube into the pleural space to drain excess fluid or air. This procedure, performed under local anesthesia and guided by imaging, helps alleviate symptoms and improve lung function. In some cases when the problem is proven to be recurrent, an indwelling pleural catheter may be inserted for long term management.

Classification of Pleural Effusion

Pleural Effusion is primarily classified into two categories based on the nature of the fluid and its underlying cause:

Exudative Effusion	Caused by inflammation or pathological changes within the pleura. Common causes include: - Pleuritis (e.g., tuberculous pleuritis). - Malignant tumours (e.g., lung, breast, or metastatic). - Autoimmune diseases (e.g., rheumatoid arthritis, systemic lupus erythematosus). - Pulmonary embolism or pancreatitis.
Transudative Effusion	It is caused by an imbalance in fluid regulation within the body, leading to fluid accumulation in the pleural cavity. Common causes include: - Heart failure (most common). - Liver cirrhosis (due to hypoalbuminemia). - Nephrotic syndrome (due to hypoalbuminemia). - Hypothyroidism.

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