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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 ...
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.
Difficulty breathing, occurring in moderate to large pleural effusions, is the most common respiratory symptom. [4] Other symptoms include fever, abdominal pain, chest pain, and reduced urination. [3] It typically occurs within hours of the causative condition. [5]
Because the transdiaphragmatic lymphatic channels are larger in diameter on the right, the pleural effusion is classically on the right side. The causes of the ascites and pleural effusion are poorly understood. [1] Atypical Meigs syndrome, characterized by a benign pelvic mass with right-sided pleural effusion but without ascites, can also occur.
Massive right sided pleural effusion later confirmed to be a hemothorax. Hemothorax, or accumulation of blood in the pleural space, can result from trauma or surgical procedures in the chest. This accumulation of blood can grow large enough to compress the lung and push away other structures in the chest, thus causing a mediastinal shift. [6]
Pleural empyema is a collection of pus in the pleural cavity caused by microorganisms, usually bacteria. [1] Often it happens in the context of a pneumonia, injury, or chest surgery. [1] It is one of the various kinds of pleural effusion.
Decubitus – taken while the patient is lying down, typically on their side. Useful for differentiating pleural effusions from consolidation (e.g. pneumonia) and loculated effusions from free fluid in the pleural space. In effusions, the fluid layers out (by comparison to an up-right view, when it often accumulates in the costophrenic angles).