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Pleural Effusion, Atelecatsis
- Pleural Effusion
- Dressler's Syndrome
- Thoracenthesis (pleural tap)
Atelectasis is an abnormal condition characterized by the collapse of lung tissue, preventing the respiratory exchange of carbon dioxide and oxygen. Atelectasis - a collapsed or airless state of the lung - may be acute or chronic, and may involve all or part of the lung. The primary cause of atelectasis is obstruction of the bronchus serving the affected area.
- Shortness of breath
- Chest pain, usually a sharp pain that is worse with cough or deep breathing
Numerous medical conditions can cause pleural effusions. Some of the more common causes are:
- Congestive heart failure
- Liver disease
- Renal disease
- Pulmonary embolism
- Lupus and other autoimmune conditions
Excessive fluid may accumulate because the body does not handle fluid properly (such as in congestive heart failure, or kidney and liver disease). The fluid in pleural effusions also may result from inflammation, such as in pneumonia, autoimmune disease, and many other conditions.
Symptoms typically appear 2-3 weeks following surgery
- May last for weeks or months
- chest pain (91%)
- Pericardial and pleural effusion
Three sequential images of the chest show a pre-op chest X ray in which the left lung base is clear (green arrow); on the third day post-op coronary artery jump bypass surgery, there is subsegmental atelectasis at the left base (yellow arrow). Four weeks later, there is a left pleural effusion and subsegmental atelectasis visible (red arrow).
General principle:Treat the medical condition causing the pleural effusion.
- Antibiotics for pneumonia, or
- Diuretics for congestive heart failure
- Anti-inflammatory medications and steroids
Large, infected, or inflamed pleural effusions often require drainage to improve symptoms and prevent complications. Various procedures may be used to treat pleural effusions, including:
- Thoracentesis or pleural tap, is a procedure to remove fluid or air (pneumothorax) from the pleural space
- Tube thoracotomy (chest tube): A small incision is made in the chest wall, and a plastic tube is inserted into the pleural space. Chest tubes are attached to suction and are often kept in place for several days.
- Pleurodesis: An irritating substance (such as talc or doxycycline) is injected through a chest tube, into the pleural space. The substance inflames the pleura and chest wall, which then bind tightly to each other as they heal. Pleurodesis can prevent pleural effusions from reoccurring, in many cases.
- Pleural drain: For pleural effusions that repeatedly reoccur, a long-term catheter can be inserted through the skin into the pleural space. A person with a pleural catheter can drain the pleural effusion periodically at home.
- Pleural decortication: Surgeons can operate with tools inside the pleural space, removing potentially dangerous inflammation and unhealthy tissue. Decortication may be performed using small incisions (thoracoscopy) or a large one (thoracotomy).