Pleural effusions are a buildup of fluid in the lining of the lung, leading to chest pain, coughing, difficulty breathing and high risk of collapsed lung. This is sometimes called “water on the lungs.” In the body, the pleura are thin membranes that line the lungs. It is normal for a small amount of fluid to be in the pleura, but when the fluid gets to be too much, it is problematic.
Symptoms
Pleural effusions have varying degrees of severity, depending on the cause of the effusion. Some people who experience pleural effusions may not experience symptoms while others may. However, symptoms include a dry, nonproductive cough, chest pain, dyspnea, which is shortness of breath, or difficult, labored breathing, and orthopnea, which is the inability to to breathe easily unless the person is sitting up or standing up straight. Pleural effusions can be caused by exposure to asbestos.
Testing
There are a multitude of tests that can be done to diagnose pleural effusions. These tests include an ultrasound of the chest, a CT scan of the chest, a chest x-ray, thoracentesis, which is when a needle is inserted to remove a sample of fluid, and a pleural fluid analysis, which is an examination of the fluid removed from the pleura. A CT scan allows doctors to do many different things. These include planning radiation therapy for cancer treatment, finding the right place for a biopsy, and learning the stage of cancer, which allows the doctor to determine which treatment options are best for the patient. A CT scan involves taking pictures of the inside of the body using x-rays. These x-rays are taken from a variety of different angles. After these tests, if the pleural effusion has still not been diagnosed, another test can be done. This test is called a thoracoscopy and it is minimally invasive. It is also known as video-assisted thoracic surgery, or VATS. This test allows for the pleura to be seen on video.
Treatment
Treatment for pleural effusions depends on aspects such as symptoms and the cause of the effusion. If the effusion cannot be drained, the patient may require surgery. The two types of surgery used to treat pleural effusions are VATS and thoracotomy. In some cases, treatment may involve chemotherapy, radiation therapy, putting medicine into the chest to stop fluid from building up again once it has been drained and leaving a small sized tube in place for a period of time in order to let the fluid drain and for the lung to expand throughout time.
Other treatment options may include using a catheter and a shunt. A catheter may be used to drain the fluid from the pleura. A catheter is a thin tube of plastic that is put into the pleural fluid. Another form of a catheter that may be utilized is called a tunneled pleural catheter (TPC), which can be inserted and left in the lungs for a long period of time to allow for continued drainage. A shunt is inserted during surgery and is used to pass and divert extra fluid from one place to another.
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Sources:
https://my.clevelandclinic.org/health/diseases/17373-pleural-effusion-causes-signs–treatment
