Pleural effusion

[Barbara Lea]

Husband Jim had a thoransenthesis (sp ??) this am to relive pleural effusion. Dr. removed 2 quarts of fluid. I did not get to see dr. to ask questions, so here I am. I understand what a pleural effusion is, but where does all the fluid come from and will this keep reoccurring? What happens if he doesn't have it removed? He has been stubborn through his whole diagnosis and treatment, but did agree to the procedure today only becuase he was having sob, tightness in his chest and extreme shoulder pain. When he had surgery last Dec. he had cancer cells in the pelural fluid, thats why he had chemo. They will biopsy this new fluid. Dr. did mention that if fluid builds up monthly he can put some kind of powder in there to buid a wall. Any input would be appreciated. [/img]

[RandyW]

This should help clarify things a little bit! Sending prayers

Medical Encyclopedia: Pleural effusion

URL of this page: http://www.nlm.nih.gov/medlineplus/ency ... 000086.htm

Alternative names

Fluid in the chest; Pleural fluid

Definition

A pleural effusion is an accumulation of fluid between the layers of the membrane that lines the lungs and chest cavity.

Causes, incidence, and risk factors

Your body produces pleural fluid in small amounts to lubricate the surfaces of the pleura, the thin membrane that lines the chest cavity and surrounds the lungs. A pleural effusion is an abnormal collection of this fluid.

Two different types of effusions can develop:

Transudative pleural effusions are often caused by abnormal lung pressure. Congestive heart failure is the most common cause.

Exudative effusions form as a result of inflammation (irritation and swelling) of the pleura. This is often caused by lung disease. Examples include lung cancer, pneumonia, tuberculosis and other lung infections, drug reactions, asbestosis, and sarcoidosis.

Symptoms

Shortness of breath

Chest pain, usually a sharp pain that is worse with cough or deep breaths

Cough

Hiccups

Rapid breathing

There may be no symptoms.

Signs and tests

During a physical examination, the doctor will listen to the sound of your breathing with a stethoscope and may tap on your chest to listen for dullness.

The following tests may help to confirm a diagnosis:

Chest x-ray

Thoracic CT

Ultrasound of the chest

Thoracentesis

Pleural fluid analysis

The cause and type of pleural effusion is usually determined by thoracentesis (a sample of fluid is removed with a needle inserted between the ribs).

Treatment

Treatment may be directed at removing the fluid, preventing its re-accumulation, or addressing the underlying cause of the fluid buildup.

Therapeutic thoracentesis may be done if the fluid collection is large and causing pressure, shortness of breath, or other breathing problems, such as low oxygen levels. Treatment of the underlying cause of the effusion then becomes the goal.

For example, pleural effusions caused by congestive heart failure are treated with diuretics and other medications that treat heart failure. Pleural effusions caused by infection are treated with antibiotics specific to the causative organism. In patients with cancer or infections, the effusion is often treated by using a chest tube to drain the fluid. Chemotherapy, radiation therapy, or instilling medication within the chest that prevents re-accumulation of fluid after drainage may be used in some cases.

Expectations (prognosis)

The expected outcome depends upon the underlying disease.

Complications

A lung surrounded by a fluid collection for a long time may collapse.

Pleural fluid that becomes infected may turn into an abscess, called an empyema, which requires prolonged drainage with a chest tube placed into the fluid collection.

Pneumothorax (air within the chest cavity) can be a complication of the thoracentesis procedure.

In rare cases, surgery is needed to remove the abscess.

Calling your health care provider

Call your health care provider if symptoms suggestive of pleural effusion develop.

Call your provider or go to the emergency room if shortness of breath or difficulty breathing occurs immediately after thoracentesis.

Update Date: 8/7/2006

Updated by: David A. Kaufman, M.D., Assistant Professor, Division of Pulmonary, Critical Care & Sleep Medicine, Mount Sinai School of Medicine, New York, NY. Review provided by VeriMed Healthcare Network.

[Barbara Lea]

Thanks for the info Randy. It helped clear some things up. I am finding that with this disease there is always something new around the corner to learn. Thanks again.

[Welthy]

Barbara,

Your husband sounds as stubborn as mine! Two liters is roughly equivalent to 2000 cc's. YIKES -- no wonder he was having such difficulty.

If you look at my husband's history below, you will see that he has refused to do the Pleurodesis (talc) procedure and just keeps getting tapped. I think he's up to 13 or 14 now. I understand his fear of more invasive stuff being done to him and he is worried that he will be SOB permanently if he has the procedure done. He also would have to be in the hospital 4-5 days for each side and that would also be a big no-no for him.

His effusion is slowing even if his cancer isn't lately, but his is more of a reaction to long term taxotere use.

Hoping for clear pathology on your hubby's fluid! The fun never stops.

Welthy