Pleural Effusion

Overview

A pleural effusion is the accumulation of fluid in the space between the lungs and the chest wall.  

There are many conditions that may cause pleural effusion:

  • Lung infection (pneumonia)
  • Cancer (lung cancer, mesothelioma)
  • Congestive heart failure
  • Kidney failure
  • Liver Cirrhosis
  • Trauma

Pleural effusion may have the following common symptoms:

  • chest pain
  • difficulty breathing
  • pleurisy or painful breathing
  • either a dry cough or a productive cough
  • presence of fever, chills, and loss of appetite

Diagnosis and Treatment

To properly diagnose if you have a pleural effusion, your doctor will review your medical history and will perform a  physical exam

They will then will most likely order for a chest x-ray to see if there is a pleural effusion. If present, this would normally be a whitish area in the lungs on one or both sides. Your doctor may also order for a CT scan or ultrasound to further identify the possible cause and the extent of the pleural effusion.  It is important that if there is any abnormal amount of fluid present in the lungs that it be sampled to determine the cause and required treatment for your condition:

  • Thoracentesis: uses a needle or small catheter to remove fluid, effectively treating many pleural effusions. This procedure is usually performed using ultrasound guidance by your lung specialist
  • Tube thoracostomy or chest tube: a small incision is made in the chest wall and a plastic tube is inserted into the pleural space to suction out the fluid, often kept in place for several days
  • Pleurodesis: Under general anaesthetic, an irritating substance (sterile talc) is injected through a small hole between the ribs into the pleural space. The talc inflames the pleura (lining of the lung and chest wall) causing the lung and inner chest wall to bind tightly to each other as they heal. This can prevent pleural effusions from recurring, in many cases.
  • Pleural drain: for pleural effusions that recur repeatedly, a long-term catheter can be inserted through the skin into the pleural space. Patients with a pleural catheter can drain the pleural effusion periodically at home.
  • Pleural decortication: This surgery is performed inside the pleural space, removing potentially dangerous inflammation, infection and unhealthy tissue. It may be performed using small incisions (video-assisted thoracoscopy (VATS)) or a larger incision (thoracotomy)

Antibiotics may be given should there be any infections. Remember to adhere to your doctor's orders when taking medications. Know the names of your medications, what they are for, and how often to take them.

Recovery

Before you go home, your nurse will teach you how to use any equipment you might need, how to care for your incision, and review your medications with you. Gradually, over the course of a few weeks, you will regain your strength and be able to return to work and participate in physical activity. Be sure to call your doctor if you notice any of the following:

  • Bleeding
  • Infection
  • High temperature
  • Allergic reaction, such as redness, swelling, trouble breathing
  • Pain
  • Any of the aforementioned symptoms, whether mild or severe

Always take your medicine exactly as prescribed. Call Dr Orr if you have any questions or changes.

  • The Children's Hospital at Westmead
  • Heart Centre for Children- The Children's Hospital at Westmead
  • Sydney Children's Hospital Randwick
  • Westmead Hospital
  • Westmead Private Hospital
  • Royal Australasian College of Surgeons
  • International Society for Heart and Lung Transplantation
  • Sydney Adventist Hospital