Understanding Pleural Effusion: Causes, Symptoms, and Treatment Options
Pleural Effusion, a medical condition marked by the buildup of fluid in the pleural cavity, poses a significant health concern.
This accumulation occurs between the thin membranes lining the chest cavity and enveloping the lungs, known as the pleura.
Comprehensive knowledge of the causes, symptoms, and available treatment avenues for Pleural Effusion is crucial for effectively addressing and managing this condition.
What is Pleural Effusion?
Pleural Effusion, sometimes called “water on the lungs,” results from an abnormal buildup of fluid within the pleural layers.
These layers consist of thin membranes that encase the lungs and line the chest cavity.
These membranes typically contain a small amount of fluid, serving as a lubricant to facilitate the movement of the lungs during breathing.
However, in cases of pleural effusion, there is an imbalance where the body either produces an excess of fluid or fails to absorb it adequately, leading to an accumulation around the lungs.
Pleural Effusion Types
Pleural Effusion is classified into two primary types, distinguished by the nature of the fluid surrounding the lungs:
- Transudative Pleural Effusion: This effusion involves protein-poor and watery fluid. It typically occurs due to conditions such as cirrhosis or heart failure, where there is an increase in pressure, causing fluid to accumulate around the lungs.
- Exudative Pleural Effusion: In this type, the fluid around the lungs is rich in proteins. Exudative Pleural Effusion is often associated with conditions like cancer or infections, where there is an abnormal fluid leakage from blood vessels or inadequate drainage by the lymphatic system.
Pleural Effusion Causes
Causes of pleural effusion can include:
- Congestive heart failure
- Cirrhosis or poor liver function
- Pulmonary embolism, resulting from a blood clot blocking the lung arteries
- Complications from open-heart surgery
- Pneumonia
- Severe kidney disease
- Autoimmune diseases like lupus and rheumatoid arthritis
- Certain medications such as methotrexate, phenytoin, or amiodarone
- Radiation therapy
- Rupture of the aesophagus
- Ovarian hyperstimulation syndrome
- Specific cancer varieties like lung cancer and breast cancer
Pleural Effusion Symptoms
Symptoms of Pleural Effusion may include:
- Chest pain exacerbated by coughing or deep breathing.
- Dyspnea (shortness of breath) or difficulty breathing.
- Orthopnea (discomfort in breathing except when sitting or standing straight)
Some individuals may not experience any symptoms and only discover they have Pleural Effusion through a chest X-ray conducted for another purpose.
Pleural Effusion Treatment
Treating Pleural Effusion focuses primarily on addressing the underlying cause. The aim is to effectively treat the root cause of fluid accumulation in the pleural space.
1- Draining fluid
- Draining excess fluid from the chest cavity is a common approach to treating Pleural Effusion. This can be done through needle aspiration or inserting a small tube into the chest.
- Prior to the procedure, you’ll be given a local anaesthetic to reduce any discomfort. Some pain or discomfort may occur at the incision site after the anaesthetic wears off, but pain relief medication can help manage this.
- If fluid buildup recurs, the procedure may need to be repeated. In cases where cancer is the underlying cause, additional treatments may be necessary to address fluid accumulation effectively.
2- Antibiotics
- In cases of bacterial infection, antibiotics are typically prescribed by the doctor, either orally or intravenously.
- Often, this treatment is combined with drainage procedures to effectively manage the disease and reduce fluid accumulation in the chest cavity.
3- Pleurodesis
- Pleurodesis is a procedure aimed at creating controlled inflammation between the layers of the pleura surrounding the lungs and chest cavity.
- After excess fluid is removed from the chest cavity, a medication is injected into the area. This medication prompts adhesion between the pleural layers, preventing fluid accumulation in the future.
- Typically performed in pleural effusion caused by cancer, pleurodesis helps reduce the necessity for frequent drainage procedures.
4- Surgery
- If drainage procedures or pleural sclerosis prove ineffective, surgery may be necessary to address Pleural Effusion. Your surgeon will conduct a thorough assessment and provide detailed discussions regarding the potential risks and benefits of surgical interventions for pleural effusion.
Two primary surgical approaches are available:
1. Video-assisted thoracoscopic surgery (VATS)
- This minimally invasive method involves making one to three small incisions (typically half-inch) in the chest.
- VATS is suitable for managing challenging-to-drain pleural effusions or those recurring due to a tumour.
- During the procedure, sterile talc or antibiotics may be introduced to prevent future fluid buildup.
2. Thoracotomy (traditional, open thoracic surgery)
- A Thoracotomy entails making a larger incision, usually 6 to 8 inches, in the chest. This approach is employed when dealing with infections.
- Through a thoracotomy, surgeons remove fibrous tissue and clear out infections from the pleural space.
- Following surgery, chest tubes are often required for drainage, typically for a period ranging from two days to two weeks.
Pleural Effusion Recovery
Following a thoracentesis, it’s advisable to rest for approximately two days. In the case of VATS, a hospital stay of a few days might be necessary post-surgery.
However, after undergoing a thoracotomy (open surgery), expect to remain hospitalised for about a week.
Choose Dr Taj Chowdhry for Pleural Effusion treatment in Abu Dhabi
Choose Dr Taj Chowdhry for expert Pleural Effusion treatment in Abu Dhabi. As a Consultant Thoracic Surgeon, Dr. Taj Mohammed Fiyaz Chowdhry brings extensive experience and exceptional skill to the cardiothoracic field.
With an MD distinction from Leicester University, UK, he leads the Thoracic Surgical Team at Burjeel Hospital, Abu Dhabi.
Dr. Taj specialises in complex procedures and has developed a unique and highly effective approach. Patients across the UAE trust him for his expertise and compassionate care, knowing they are in capable hands under his supervision.
