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04 ArijitD Medicine Introduction

04 ArijitD Medicine Introduction

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Published by: Lakshya J Basumatary on Jul 14, 2009
Copyright:Attribution Non-commercial


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leural effusion is a common complication of many disease processeseither local or systemic.
Pleural effusion refers to excess pleural fluid formation from the parietal pleura or the interstitial spaces of lung or secondarily from peritonealcavity or when there is decrease fluid removal by the lymphatics. The firststep in the approach to a patient with pleural effusion is to determine whether the effusion is transudative or exudative. A transudative effusion occurs whensystemic factors that influence the formation and absorption of fluid arealtered and an exudative effusion occurs when local factors influencing theformation and absorption are altered.The most common cause of transudative pleural effusion iscongestive heart failure (60 to 70%; Glazier J B
et al 
), cirrhosis of liver andascites (5%; Lieberman F L
et al 
1966 & Lieberman 1970). In many parts of the world the most common cause of an exudative pleural effusion istuberculosis. Malignant pleural effusion secondary to metastasis are secondmost common (75% of all malignant pleural effusion are lung carcinoma, breast carcinoma and lymphoma) (Richard W Light, 2001).An extensive diagnostic work up is needed in cases withexudative effusion to know the cause (Light
et al 
1972). For these various parameters were evaluated but until recent time the Light criteria establishedin 1972, was found to distinguish exudative plural effusion from transudative pleural effusion.However in the recent years several reports indicated that thesecriteria misclassified a number of pleural effusions and for this several parameters were assessed, nevertheless all these alternatives falsely classified

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