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Exudative pleural effusion What is Pleural Effusion Part 3 - Dr Sheetu Singh

Exudative Pleural Effusion What is Pleural Effusion Part 3 - Dr Sheetu Singh www.drsheetusingh.com

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Exudative pleural effusion What is Pleural Effusion Part 3 - Dr Sheetu Singh

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  1. Exudative pleural effusion Obstetric and gynecologic disease Ovarian hyperstimulation syndrome Postpartum pleural effusion Meigs' syndrome Endometriosis Collagen vascular diseases Rheumatoid pleuritis Systemic lupus erythematosus Drug-induced pleural disease Nitrofurantoin Dantrolene Methysergide Ergot drugs Miscellaneous diseases and conditions Asbestos exposure Postlung transplant Postbone marrow transplant Yellow nail syndrome Sarcoidosis Uremia Trapped lung Therapeutic radiation exposure Drowning Amyloidosis Acute respiratory distress syndrome J. Hemothorax K. Chylothorax • Neoplastic diseases • Metastatic disease • Mesothelioma • Body cavity lymphoma • Infectious diseases • Bacterial infections • Tuberculosis • Fungal infections • Parasitic infections • Viral infections • Pulmonary embolization • Gastrointestinal disease • Pancreatic disease • Subphrenic abscess • Intrahepatic abscess • Intrasplenic abscess • Esophageal perforation • Postabdominal surgery • Heart diseases • Postcoronary artery bypass graft surgery • Postcardiac injury (Dressler's) syndrome • Pericardial disease

  2. Pleural fluid glucose Most patients with a reduced pleural fluid glucose level (<60 mg/dL) have one of four conditions: • parapneumonic effusion • malignant pleural effusion • tuberculouspleuritis • rheumatoid pleural effusion

  3. Hemothorax • Pleural fluid hematocrit > 50% • Causes: • Traumatic • Iatrogenic – central venous line insertion • Non traumatic – metastatic malignant pleural effusion, anticoagulant therapy, pulmonary embolism

  4. Sub-pulmonic / Infra-pulmonary effusion (a) apparent elevation of one or both diaphragms (b) PA view, the apex of the apparent diaphragm is more lateral than usual, near the junction of the middle third and the lateral third of the diaphragm, rather than at the center of the diaphragm (c) the apparent diaphragm slopes much more sharply toward the lateral costophrenic angle (d) if the subpulmonic effusion is on the left side, the lower border of the lung is separated farther from the gastric air bubble than usual (>2 cm) (e) Lateral view, the major fissure often bows anteriorly where it meets the convex upper margin of the fluid; a small amount of fluid is usually apparent in the lower end of the major fissure at its junction with the infrapulmonary effusion

  5. Subpulmonic pleural effusion. • A: Posteroanterior chest radiograph showing apparent elevation of the left diaphragm with the apex of the apparent diaphragm more lateral than usual. • B: Lateral decubitus film of another patient showing free pleural fluid.

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