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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

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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

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Risk Factors

  • iatrogenically from surgery

  • trauma

  • malignancy (especially lymphoma)

  • left-heart failure

  • infections

  • developmental abnormalities (Down syndrome, Noonan syndrome)

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Diagnosis

  • triglyceride level

  • "milky" looking fluid

  • give patient milk shake

  • lymphangiogram

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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

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PseudoChylothorax

  • high cholesterol pleural effusion

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Diagnosis

  • cholesterol level

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Treatment

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  • IR lymphatic embolization

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