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Pleural Effusion is a collection of fluid around the lung (in the pleural space) which causes breathlessness when a large amount has accumulated.

The causes of a pleural effusion include:

  • Pneumonia
  • Tuberculosis
  • Heart Failure
  • Cancer – lung or others (e.g. breast or ovary)
  • Rheumatoid Arthritis

The diagnosis is made on the basis of drawing this fluid off and sending it to the laboratory for analysis. This is not always successful in getting a diagnosis, so occasionally a thoracoscopy is needed. Thoracoscopy is a telescope test performed in Specialist Centres – in our region patients go to Oxford for this test. The telescope is placed inside the chest via small hole and bigger biopsies can be taken this way and any extra fluid drained.

If the diagnosis is known and the fluid build up is causing significant breathlessness, a chest drain can be inserted to drain off all the fluid – often there can be over 2 litres in the chest.

In certain circumstances such as cancer, the fluid may repeatedly accumulate and so to prevent this, pleurodesis is performed. This sticks down the lining of the lung, preventing further fluid reaccumulation. It is usually about 85% effective. (See pleurodesis leaflet)

In the case of infection in the pleural space (called an empyema), antibiotics and drainage is often adequate to achieve a cure, but occasionally, the infection does not come under control and surgery is required to drain the pus out of the chest. Should it become necessary, this is usually done at Harefield Hospital.



patients UK/pleural effusion