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Pleural Effusion

What is pleural effusion?

Pleural effusion is the buildup of excess fluid in the space between the lungs and the ribcage. Pleural effusion prevents the lungs from fully expanding during breathing.

What is the cause?

The space between the lungs and the ribcage is the pleural cavity. Normally, there is a small amount of fluid in this space that acts as a lubricant and allows the lungs to expand smoothly during breathing. When there is too much fluid in the chest, there is less room for the lungs to expand when you breathe. Some conditions can cause excess fluid to build up in the pleural cavity. The excess fluid is either thin, almost like water, or thick, like pus.

Conditions that produce thin fluid are:

  • Heart failure
  • Salt retention, which causes swelling
  • Tumor, such as a tumor of the lung, breast, or ovary
  • A big change in body fluids, such as after childbirth
  • Cardiac bypass graft surgery

Conditions that produce thick fluid include:

  • Bacterial pneumonia
  • Lung cancer, breast cancer, or cancer in the lymph system
  • Tuberculosis
  • Rheumatic diseases

What are the symptoms?

If the excess fluid is thin and watery, symptoms may include:

  • No pain
  • Shortness of breath

If the excess fluid is thick, symptoms may include:

  • Chest pain
  • Shortness of breath
  • Fever

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you.

Tests may include:

  • Chest X-rays
  • Ultrasound scan, which uses sound waves to show pictures of the chest
  • CT scan, which uses X-rays and a computer to show detailed pictures of your chest

You may need a thoracentesis, which is a way to get a fluid sample from your lungs. After numbing the area, your healthcare provider inserts a needle through a space between your ribs and draws out some fluid. The sample of fluid is sent to a lab for testing. In addition, if there is a lot of fluid, much of it can be removed and you will be able to breathe easily.

Your healthcare provider may order a biopsy if he or she thinks you may have tuberculosis (TB) or a tumor. For a biopsy, your provider takes fluid and tiny samples of tissue from the lung. This can usually be done in a way similar to how the thoracentesis is done. The samples are sent to a lab for tests.

How is it treated?

Excess fluid can be removed in different ways:

  • Thoracentesis
  • A chest tube attached to gentle suction. The chest tube can keep fluid from building up again as long as it is in place.

These procedures are usually done in the hospital, often in the emergency room.

When your provider has the results of your tests, he or she will also treat the disease causing the fluid buildup.

Your provider may give you pain medicine. If you have only minor discomfort and are breathing without difficulty, you may leave the hospital. Usually, you will stay in the hospital if any of the following happen:

  • There is pus in the fluid.
  • There is a pocket of pus in the lung cavity (an abscess).
  • You have trouble breathing.
  • You have a lot of discomfort.

You will also stay at the hospital if any of the following are likely:

  • A blood clot (embolism)
  • Severe heart failure
  • Lung inflammation (pneumonitis)

In some cases you may need surgery to drain the area or to get a sample of tissue for diagnosis.

How can I take care of myself?

Ask your healthcare provider:

  • How and when you will hear your test results
  • How long it will take to recover
  • What activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

How can I help prevent pleural effusion?

Most pleural effusions cannot be prevented. Some pleural effusion may be prevented by early diagnosis and treatment of the underlying condition.

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Published by RelayHealth.
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