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Pleural Effusion

Supine Patient

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Pleural effusion

Loss of right iaphragmatic and cardiac silhouettes

Loculation evident in lateral view

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Line not corresponding to fissure

Exudate

• Usually 2° neoplastic or inflammatory

dzs involving pleura

• [Fluid Protein] -;- [serum protein] > 0.5

• [Fluid LDH] -;- [serum LDH] >0.6

• Fluid LDH > 2/3 highest normal serum LDH

Pleural Effusion

Transudative vs Exudative

• Although anabsence of pleural thickening is compatible witheither atransudative 0[' exudativeeffusion (including those associatecl ··with.fD.etastatic. d,isease),this·.:effective1y

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eliminate san.ernpyerna .

• Lack of pleural thickening or enhancement does notexclude infectionofa pleutalfluid collection,

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Side-specificity

• Mostly left-sided

• Pancreatitis

• Dressler's syndrome

• Distal thoracic duct obstruction

• Mostly right-sided

• Heart failure

• Abdominal disease related to liver or ovary

• Proximal thoracic duct obstruction

Hydropneumothorax

• If both a pneumothorax and a pleural effusion occur together, it is called a hyd ropneu mothorax

• A hydropneumothorax is usually due to trauma, surgery, bronchopleural fistula

• It is characterized by an air-fluid level in the hemithorax

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Chylothorax

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