Pleural Effusion

last updated: April 9, 2017

Orlando Debesa

Video

Pleural Effusions - part 3

Pleural Effusions - part 1

Pleural Effusion - Dx & Tx

Pleural Effusions - part 2

Transudate vs Exudate

Pleural Effusion

Sign / Symptoms

  • shortness of breath pain

  • dry cough

  • pleurisy (pain with inhalation)

Chylothorax

  • high triglyceride pleural effusion

  • high mortality especially if has high output because of immunosuppression

Risk Factors

  • iatrogenically from surgery

  • trauma

  • malignancy (especially lymphoma)

  • left-heart failure

  • infections

  • developmental abnormalities (Down syndrome, Noonan syndrome)

Diagnosis

  • triglyceride level

  • "milky" looking fluid

  • give patient milk shake

  • lymphangiogram

Treatment

  • conservative if low output

  • TPN

  • octreotide (takes a few weeks to work)

  • IR lymphatic embolization

  • pleuralperitoneal shunting

  • omitting free fatty acids from diet

  • pleurodesis

  • surgical ligation of thoracic duct with partial pericardectomy

PseudoChylothorax

  • high cholesterol pleural effusion

Diagnosis

  • cholesterol level

Treatment

  • IR lymphatic embolization

... but I would more especially commend the clinician who, in acute diseases, by which the bulk of mankind are cutoff, conducts the treatment better than others.
 
Hippocrates, 400 BC