Section 2 ：
Pneumothorax
Section 1 Pleural Effusion
Learning goals
Summary of the pleura Etiology and pathogenesis Clinical presentations Laboratory findings Imaging Diagnosis and differential diagnosis Treatment
Etiology and pathogenesis
5.Others. infection in the pleural space(empyema) bleeding into the pleural
space(Hemothorax) esophageal rupture
Symptoms
Dyspnea Chathogenesis
3.Increased production of fluid due to abnormal capillary permeability. pneumonia(parapneumonic effusion) cancer bacterial infection tuberculosis
Etiology and pathogenesis
4.Decreased lymphatic clearance of fluid from the pleural space. thoracic duct obstruction or
rupture(e.g. malignancy, trauma) producing exudates
Symptoms
Chest pain
may be mild or severe It typically is described as sharp or
stabbing, exacerbated with deep inspiration, and pleuritic If pleural effusion increases, chest pain may diminishes in intensity Dry pleurisy cause direct pleural irritation.
1.Increased production of fluid in the setting of normal capillaries due to increased hydrostatic
heart failure (≈90% of cases) superior vena cava obstruction pulmonary embolism(PE)
Note: Different etiology, different amount of effusion, different clinical manifestations
Symptoms
Dyspnea is the most common clinical symptom at
presentation which indicates a large effusion(usually >500ml)and is reported to occur in 50% of patients with malignant pleural effusions.
Summary of the pleura
The filtration and absorption of pleural effusion are in a dynamic balance.
Any reason cause excessive production of pleural effusion ,more than absorption, fluid appear
Circulation mechanism of pleural effusion
The drainage of
pleural effusion
mainly depends on
the reabsorption of
parietal pleural
lymphatics
Etiology and pathogenesis
Summary of the pleura
The pleural cavity is a potential space between the lung and the chest wall.
A normal person's pleural cavity contains a small amount of fluid (1015ml) as a lubricant.
1.increased hydrostatic 2.decreased colloid osmotic pressures. 3.abnormal capillary permeability. 4.Decreased lymphatic clearance. 5.Others.
Etiology and pathogenesis
Etiology and pathogenesis
2.Increased production of fluid in the setting of normal capillaries due to decreased colloid osmotic pressures. crrhosis with ascites nephrotic syndrome peritoneal dialysis
Pleural Diseases
The pleural cavity is a potential space between the lung and the chest wall
Pleural Effusion
Pneumothorax
Section 1 ：
Pleural Effusion