Pleural Disease

The thin membrane that lines your lung and the inside of your ribs is called the pleura. Pleural disease can affect various parts of this lining. These two linings are usually separated by a very thin amount of lubricating fluid. It is like a built in protector, but sometimes things can happen that disrupt the synergy of these linings and it can create problems such as too much fluid, a collapsed lung, or irritation of the lining. Too much fluid is called a pleural effusion. A collapsed lung is called a pneumothorax. Irritation of the pleura is called pleurisy. Sometimes infection or pneumonia can affect the pleura and this is called empyema.

Some causes of pleural effusion:

• Heart failure
• Lung cancer
• Pneumonia
• Liver disease
• Complications of dialysis or renal disease
• Infection
• Rheumatologic disease (autoimmune)

Some causes of pneumothorax:

• “Blebs” of the lung that collapse (can be seen in young, tall patients)
• COPD
• Tuberculosis
• Trauma

Some causes of pleurisy:

• Viral infections
• Bacterial infections
• Cancer
• Rheumatoid arthritis
• Certain medications
• Mesothelioma

The symptoms of pleural disease may vary based on the underlying cause.
Common symptoms include:

• Shortness of breath
• Chest pain near the ribs
• Fatigue
• Cough

How are pleural diseases treated?

The first step to diagnosis is an evaluation by your doctor including medical and family history, physical exam, and risk factor evaluation. No single test is used to evaluate pleural disease. Some common tests include a chest X-ray, CT scan, and sometimes blood tests. Often before seeing a thoracic surgeon patients have been evaluated by a pulmonologist or primary care doctor.

Maybe pleural surgeries are performed with a minimally invasive approach using a camera and two small ports. Usually three incisions total. After pleural surgery a chest tube will be left in place coming out between the ribs to drain fluid and /or air from the pleural cavity.

A pleural effusion may be treated with simple drainage, an indwelling tube or a procedure called a pleurodesis. The purpose of the pleurodesis is to create scar tissue either by mechanical abrasion or instillation of talcum powder to obliterate the space between the lung and chest wall. This is called a pleurodesis. A successful pleurodesis will cause the lung to “stick” to the ribs so that fluid does not occur in this space. The body will then absorb the fluid and excrete via the kidneys.

A pneumothorax can be treated with a chest tube to evacuate the air. After the first occurrence a surgery may be required to create scar tissue either by mechanical abrasion or instillation of talcum powder to obliterate the space between the lung and chest wall. This is called a pleurodesis. A successful pleurodesis will cause the lung to “stick” to the ribs so that if the lung develops a leak or hole in the future the lung will not collapse.

Pleurisy is often treated with medications such as anti-inflammatories, time, and treatment of the underlying cause.

Your doctor will discuss what treatment is recommended and explain the specific disease process.

Want to know more?
https://ctsurgerypatients.org/lung-esophageal-and-other-chest-diseases/pleural-diseases