Pleural Effusion

Pleural effusion (“fluid around the lungs”) is a condition in which too much fluid accumulates between the lungs and the inside of the chest cavity. The fluid accumulation can prevent the chest and lungs from fully expanding and can put pressure on the diaphragm, limiting the function of the lung. The larger the amount of fluid, the less the lung can expand.

Pleural fluid accumulation can result from excess fluid production, reduced fluid removal, or both. Types of pleural effusion include thin, non-infected fluid (hydrothorax), blood (hemothorax), urine (urinothorax), chyle or fatty fluid from digestion (chylothorax), or pus (empyema).

The thoracic surgeons at UT Southwestern Medical Center perform advanced procedures to treat pleural effusion – some of which can be performed minimally invasively. We feature the latest imaging techniques and treatment options. Our surgeons work closely with interventional pulmonologists, oncologists, radiologists, and pathologists at UT Southwestern to deliver comprehensive care – all in one location, and usually on the same day.

Causes of Pleural Effusion

• Autoimmune diseases (lupus, rheumatoid arthritis)
• Cirrhosis
• Congestive heart failure
• Heart or chest surgery
• Low serum albumin or hypoalbuminemia
• Malignancy in the pleura such as lung cancer, mesothelioma, metastases
• Pneumonia
• Pulmonary embolism
• Trauma
• Uremia or kidney failure

Symptoms

Symptoms that are associated with a pleural effusion include:

• Anxiety
• Chest pain
• Chest pressure
• Cough
• Fatigue
• Fever
• Loss of appetite
• Shortness of breath with exertion and possibly at rest
• Swelling of the legs, arms, or face
• Weight loss

Diagnosis

If we suspect that you have pleural effusion, we will conduct a physical examination and order tests to confirm the diagnosis.

Tests and imaging techniques used to diagnose pleural effusion might include:

• Chest X-rays (radiographs)
• Computed tomography (CT)
• Echocardiography
• Fluoroscopy: Real-time X-ray imaging
• Thoracentesis: Drainage of a sample of fluid with a small needle to determine its cause
• Ultrasound

Treatments

Our multidisciplinary team of physicians offers treatment directed at the cause of the problem. We treat pleural effusion with minimally invasive procedures that include:

• Chest tubes to drain the effusion and determine its cause
• PleurX catheter: A small tube is positioned in the fluid pocket under local or general anesthesia and is drained into a small reservoir
• Shunting: Involves the surgical implantation of a small tube (shunt) into the chest cavity to redirect excess fluid to the abdomen for elimination
• Video-assisted pleurectomy: The surgical removal of the pleura, the membrane that encases the lungs to promote fusion between the lung and the inside of the chest cavity
• Video-assisted pleurodesis: A procedure to fuse the lung to the inside of the chest cavity to prevent fluid reaccumulation

Related Conditions

Our team treats thoracic (chest) conditions that can be associated with pleural effusion.

These include:

• Benign fibrous tumors of the pleura
• Chest trauma
• Empyema
• Malignant pleural effusion
• Mesothelioma
• Pleural nodules and masses

Clinical Trials

UT Southwestern conducts clinical trials aimed at improving the treatment of pleural effusion. Talk with your doctor to see if a clinical trial may be right for you.