Pleural Effusion
Definition
Aetiology
*common
Clinical Features
Signs
Investigations
Imaging:
Treatment
Source
Dr Gregory Haug 2014
- >30ml of fluid in pleura space
- Normal: Flow of pleural (transudate) fluid = parietal pleura -> pleura space -> visceral -> hilar lymph
Aetiology
- Transudative (filtration) causes:
- Heart failure*
- Renal failure
- Liver failure
- Exudative (secretion) causes:
- Inflammatory (PE* - infarct inflammation)/ infections (pneumonia, TB)*
- Pleural ca (1° / 2° from lung)*
*common
Clinical Features
Signs
- ↓ expansion
- No vocal fremitus (decreased in pleural effusion, increased in cosolidation)
- Non resonant
Investigations
Imaging:
- X ray
- Pleural tap
- Protein
- Glucose - ↑ metabolism (autoimmune, ca, empyema)
- LDH - tissue damage
- AFB (smear/ culture) - TB
- Cytology - WBC, Ca,
- MCS
- pH - ↓ = parapneumonic effusion
- Adenosine deaminase - lymphocytic effusion
- Amylase - ruptured oesophagus
Treatment
- Treat the cause
Source
Dr Gregory Haug 2014