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A pleural effusion is accumulation of excessive fluid in the pleural space, the potential space that surrounds each lung.Under normal conditions, pleural fluid is secreted by the parietal pleural capillaries at a rate of 0.6 millilitre per kilogram weight per hour, and is cleared by lymphatic absorption leaving behind only 5–15 millilitres of fluid, which helps to maintain a functional ...
A pleural effusion is an accumulation of fluid inside the pleural space. If this collection of fluid gets large enough, it can also push structures in the chest away from it and cause a mediastinal shift. However, a pleural effusion can also pull the mediastinal structure towards itself.
Pleural effusion involving fibrinous exudates in the fluid may be called fibrinous pleurisy, which sometimes occurs as a later stage of pleurisy. A person can develop a pleural effusion in the absence of pleurisy. For example, pneumonia, heart failure, cancer, or a pulmonary embolism can lead to a pleural effusion.
Pleural effusion obliterates the pleural vacuum and can collapse the lung (due to hydrostatic pressure), impairing ventilation and leading to type 2 respiratory failure. The condition can be treated by mechanically removing the fluid via thoracocentesis (also known as a "pleural tap") with a pigtail catheter , a chest tube , or a thoracoscopic ...
Pleural effusions may also develop following the accumulation of other fluids within the pleural cavity; if the fluid is blood it is known as hemothorax (as in major chest injuries), if the fluid is pus it is known as pyothorax (resulting from chest infections), and if the fluid is lymph it is known as chylothorax (resulting from rupture of the ...
With pleural effusion, fluid often builds up in the costophrenic angle (due to gravity). This can push the lung upwards, resulting in "blunting" of the costophrenic angle. The posterior angle is the deepest. Obtuse angulation is sign of disease. Chest x-ray is the first test done to confirm an excess of pleural fluid.
A subpulmonic effusion is excess fluid that collects at the base of the lung, in the space between the pleura and diaphragm. It is a type of pleural effusion in which the fluid collects in this particular space but can be "layered out" with decubitus chest radiographs.
A chest X-ray will show fluid in the alveolar walls, Kerley B lines, increased vascular shadowing in a classical batwing peri-hilum pattern, upper lobe diversion (biased blood flow to the superior parts instead of inferior parts of the lung), and possibly pleural effusions. In contrast, patchy alveolar infiltrates are more typically associated ...