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Pleural Effusion: Dr.S.Sesha Sai (MD), Pulmonary Medicine
Pleural Effusion: Dr.S.Sesha Sai (MD), Pulmonary Medicine
EFFUSION
• Classification
• Pathogenesis
• Etiology
• Clinical features
• Investigations
• Management
Introduction
• Pleural effusion is defined as abnormal
accumulation of fluid in the pleural
space, i.e., the space between parietal
and visceral pleura
Apical
Interlobar
Sub-pulmonic
Mediastinal
B)Based on mechanism and type of pleural fluid
Transudative (alteration in hydrostatic and oncotic pressure)
Exudative (alteration in pleural permeability)
c) Based on mechanism and type of pleural fluid
formed
Pyogenic
Chylous
Haemothorax
Pseudochylous
Hydrothorax
Urinothorax
Transudative pleural effusions
Uremia
Postradiation
Traumatic
• TRANSUDATIVE:
Renal cause: Nephrotic syndrome
Hypothyroidism
• PYOGENIC:
Lung abscess
Septicemia
Rupture of oesophagus
Tuberculosis
Lymphatic obstruction
• HEMOTHORAX:
Bleeding disorders
Drugs-anticoagulants
Pulmonary infarction
• PSEUDOCHYLOUS:
Rheumatoid pleuritis
• HYDROTHORAX:
CT Scan
Suspected empyema
• Straw-coloured
• Blood stained
• Purulent
• Chylous
Transudate & Exudate
Features Transudates Exudates
pH >7.2 <7.2
• Initiate IV antibiotics
2HRZE+4HRE