becoming a better Clinician
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)
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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