Pleural Effusion Definition fluid in the pleural space

S mptoms Signs E amination Findings

Could be as mptomatic Reduced e pansion
D spnoea Ston dull to percuss
Pleuritic chest pain Reduced air entr
Reduced vocal resonance
Trachea and mediastinum central shift awa
from affected side onl with massive effusions
Investigations mL
Ma be bronchial breathing above the effusion
CXR where the lung is compressed
Small effusions ma blunt the Signs of associated disease malignanc
costophrenic angles cache ia clubbing l mphadenopath radiation
Larger effusions show water dense marks mastectom scar stigmata of chronic
shadows with concave upper liver disease cardiac failure h poth roidism
borders meniscus sign rheumatoid arthritis SLE

T pes of Effusions

Ultrasound
To identif presence of pleural fluid
Diagnostic aspiration
G needle inserted above upper
border of appropriate rib to draw
mL pleural fluid for clinical
chemistr bacteriolog and
c tolog
Pleural biops
Parietal pleural biops if pleural fluid
anal sis inconclusive

Management Diagnosis Light s Criteria

Drainage
If s mptomatic aspirate in same wa as a
diagnostic tap or using an intercostal drain
Remove fluid slowl L h
Pleurodesis helpful for recurrent effusions
Emp emas are best drained used a chest
drain inserted under ultrasound CT guidance
Surger for persistent collections increasing
pleural thickness

Anisah Ali