Pleural effusion (abnormal chest fluid)


Description

An accumulation of fluid between the lung and its surroundings (the chest wall and diaphragm). If a pleural effusion is large (a large collection of fluid), the lung may become compressed. This can lead to difficulties breathing and pain. There are multiple causes including: heart failure, infections, cancer in the lung or surrounding the lung, renal failure, and autoimmune diseases.

Symptoms

Shortness of breath, chest pain, shortness of breath with exercise, shoulder pain.

Tests

Common tests used for diagnosis and treatment

Workup:
A history and physical exam will be performed. The lung sounds through a stethoscope can be abnormal. The following tests may help to identify and get information about a pleural effusion: chest X-ray, CT scan, ultrasound of the chest, thoracentesis (sampling of the fluid with a needle), pleural fluid analysis.

Tests:
Complete blood count (CBC), Comprehensive metabolic panel (CMP), CT Scan, Ultrasound, X-ray

Other Specific Tests: Thoracentesis, Pleural fluid analysis

Specialists:
Internal Medicine, Pulmonology, Pediatric Pulmonology

Treatment

The fluid may be removed with a needle or a catheter. Some pleural effusions improve without drainage, if an infection is treated or heart failure is treated. Depending on the cause of fluid other treatment options might include: chemotherapy to treat cancer, radiation therapy, antibiotics. If a pleural effusion repeatedly occurs, the outer surface of the lung may be treated with an irritant. This causes the lung to attach to the ribs and diaphragm by scarring (the scarring "tethers" the lung to its surrounding structures). This process is called "pleurodesis" and it prevents fluid from easily collecting again in the same space. 
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