Pleural effusion in general terms is described as “collection of water on your lungs”. If excess amount of fluids gets deposited around the lungs, it can cause pleural effusion. Pleura is the name of soft membranes that cover your lungs and chest cavity. This helps in breathing and lubricating your lungs. Under normal condition, some amount of fluid is present in the layers of lungs. But effusion occurs when there is an excess amount of fluids in pleura. Certain medical conditions can also cause pleural effusion which can cause shortness of breath and chest pain. It can be treated by inserting a thin tubing into the chest wall and draining off excess of fluids. In some cases, surgery is done.
Symptoms :
Often pleural effusion may not cause any sign if it is mild. If the pleural effusion is large sized causing inflammation, it can cause symptoms like chest pain, choking, shortness of breath and fever. Pain can be felt on the chest region if you inhale air deeply.
Causes :
Fluid accumulation between the layers of pleura of the lungs can take place due to many medical conditions. The lungs will be able to function normally when there is little watery fluid in the pleural space and when excess of fluid accumulates in the available space it becomes difficult for the lungs to perform normally.
Pneumonia, renal disease (critical stage), Congestive Heart Failure, cancer, systemic lupus and pulmonary embolism can cause pleural effusion. Live cirrhosis and open heart surgery can also cause building up of more fluids in the pleural space. In rare cases, abdominal surgery and undergoing radiation treatment can cause pleural effusion.
Types :
Pleural effusion occurs as 2 main forms.
- Complicated pleural effusion is one that causes considerable amount of fluid accumulation and inflammation. This can cause complications like developing a hard ring around the lungs impairing breathing.
- Uncomplicated effusion is building up of excess of fluid that is not causing any infection or inflammation.
Diagnosis :
Your doctor will listen to your symptoms and complete physical exam. He would gently tap on your chest and do other possible physical exam to detect pleural effusion. He would request for chest X-ray to identify pleural effusion which would be visible as plain white space beneath the lung. He may also order for CT scan or ultrasound scan to get clear picture of the lungs. A sample of fluid is taken using a needle inserted between your ribs and tested in the lab for ascertaining its character. This process is called as thoracentesis.
Treatment :
Underlying cause for pleural effusion is first detected and accordingly treatment is given. In case pneumonia infection is causing effusion, your doctor may prescribe antibiotics. Diuretic drugs are given for treating congestive heart failure. Excess amounts of fluid are removed from the pleural space by draining off the same using catheter.
An incision is made in the wall of your chest through which a tiny tube is inserted into the sac surrounding the lungs and accumulated fluid is removed. This procedure is known as tube thoracotomy. For people with repeated infections of pleural effusion, a catheter is inserted directly into the pleural area permanently which would drain off excess of fluids.
- Surgery :
In thoracoscopic surgery, several small incisons are made in the chest wall to drain off unwanted fluids. This is minimally invasive surgery. In thoracotomy surgery, approximately 6 inches incision is made to remove unwanted tissue and infection causing fiber from the pleural space. The chest tube will remain intact for few weeks after surgery for complete draining of fluid. In pleural decortications, your surgeon would remove unwanted tissue present in the pleural space.
