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Pleural effusion

Fluid in the chest; Fluid on the lung; Pleural fluid

A pleural effusion is a buildup of fluid between the layers of tissue that line the lungs and chest cavity.

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Lungs
Respiratory system
Pleural cavity

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Causes

The body produces pleural fluid in small amounts to lubricate the surfaces of the pleura. This is the thin tissue that lines the chest cavity and surrounds the lungs. Pleural effusion is an abnormal, excessive collection of this fluid.

There are two types of pleural effusion:

Risk factors of pleural effusion may include:

Symptoms

Symptoms can include any of the following:

Sometimes there are no symptoms.

Exams and Tests

Your health care provider will examine you and ask about your symptoms. The provider will also listen to your lungs with a stethoscope and tap (percuss) your chest and upper back.

Chest CT scan or a chest x-ray may be enough for your provider to decide on treatment.

Your provider may want to perform tests on the fluid. If so, a sample of fluid is removed with a needle inserted between the ribs. Tests on the fluid will be done to look for:

Blood tests that may be done include:

If needed, these other tests may be done:

Treatment

The goal of treatment is to:

Removing the fluid (thoracentesis) may be done if there is a lot of fluid and it is causing chest pressure, shortness of breath, or a low oxygen level. Removing the fluid allows the lung to expand, making breathing easier.

The cause of the fluid buildup must also be treated:

In people with cancer or infection, the effusion is often treated by using a chest tube to drain the fluid and treating its cause.

In some cases, any of the following treatments are done:

Outlook (Prognosis)

The outcome depends on the underlying disease.

Possible Complications

Complications of pleural effusion may include:

When to Contact a Medical Professional

Call your provider or go to the emergency room if you have:

Related Information

Heart failure - overview
Cancer
Community-acquired pneumonia in adults
Pulmonary tuberculosis
Asbestosis
Sarcoidosis
Collapsed lung (pneumothorax)

References

Blok BK. Thoracentesis. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 9.

Broaddus VC, Light RW. Pleural effusion. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 79.

Mccool FD. Diseases of the diaphragm, chest wall, pleura and mediastinum. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 99.

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Review Date: 7/28/2018  

Reviewed By: Denis Hadjiliadis, MD, MHS, Paul F. Harron, Jr. Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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