Pleural conditions: pleural effusion and pleural empyema
The lungs are wrapped in a thin membrane called the pleura. This is made up of two layers: the visceral pleura, which covers the lungs, and the parietal pleura, which lines the inside of the chest cavity. Between the two layers is a virtual space, called the pleural cavity, which contains a small amount of pleural fluid. This fluid lubricates the movement of the lungs during breathing.
What are pleural effusion and pleural empyema?
Pleural effusion is the excessive accumulation of fluid in the pleural cavity. This fluid can be serous (clear fluid), bloody (contains blood), chylous (contains lymph) or purulent (contains pus).
Pleural empyema is an infection of the pleural cavity, characterized by the presence of pus in the pleural cavity.
Causes of pleural effusion and pleural empyema
The causes of pleural effusion are multiple and include:
- Heart failure: the most common cause of pleural effusion.
- Infections: pneumonia, tuberculosis, acute bronchitis.
- Cancer: lung, pleural, breast, ovarian.
- Inflammatory diseases: systemic lupus erythematosus, rheumatoid arthritis.
- Pulmonary embolism: blockage of a pulmonary artery by a blood clot.
- Pancreatitis: inflammation of the pancreas.
- Chest trauma: injury to the rib cage or lungs.
Pleural empyema is usually caused by a bacterial infection, which can spread from the lungs (pneumonia), esophagus, or blood.
Symptoms of pleural effusion and pleural empyema
Symptoms may vary depending on the amount of fluid accumulated in the pleural cavity and the cause of the overflow. The most common symptoms include:
- Dyspnea (shortness of breath): the most common symptom, especially with exertion.
- Chest pain: can be a sharp or dull pain that gets worse with breathing.
- Cough: dry or productive.
- Fever: may be present in pleural empyema.
- Fatigue: feeling of general weakness.
Diagnosis of pleural effusion and pleural empyema
The diagnosis is based on clinical examination, chest X-ray, chest computed tomography (CT) scan and analysis of pleural fluid obtained by thoracocentesis (pleural tap).
Treatment of pleural effusion and pleural empyema
Treatment depends on the cause of the overflow and the severity of symptoms. In small, asymptomatic pleural effusions, no treatment may be necessary.
Drug treatment
- Diuretics: to remove excess fluid from the body in heart failure.
- Antibiotics: to treat bacterial infections.
- Chemotherapy: for cancer.
- Corticosteroids: to reduce inflammation.
Surgical treatment
In large pleural effusions that are symptomatic or do not respond to drug treatment, surgery is necessary. At Elytis, our thoracic surgery specialists use modern, minimally invasive techniques to ensure the best outcomes for patients.
Surgical procedures
- Thoracentesis: is a minimally invasive procedure that involves inserting a needle into the pleural cavity to drain accumulated fluid.
- Pleural drainage: a drainage tube is inserted into the pleural cavity to drain fluid.
- Pleurodesis: is a surgical procedure that aims to obliterate the pleural cavity to prevent fluid from reaccumulating.
- Thoracoscopy: is a minimally invasive surgical procedure that allows direct visualization of the pleural cavity and the performance of surgical interventions such as pleural biopsy or pleural decortication (removal of thickened pleura).
- Thoracotomy: is a classic surgical procedure that involves opening the rib cage. It is used in complex cases such as pleural empyema with bronchopleural fistulas.
Minimally invasive thoracic surgery at Elytis
The Elytiswe are dedicated to providing the best medical care for our patients. Our thoracic surgery specialists use minimally invasive techniques, such as thoracoscopy and video-assisted surgery, to treat pleural conditions. These techniques have many advantages over traditional surgery, such as:
- Smaller incisions: reduce postoperative pain and the risk of complications.
- Faster recovery: patients can return to normal activities sooner.
- Superior aesthetic results: smaller and less visible scars.
When to see a doctor:
It is important to see a doctor if you have symptoms suggestive of pleural effusion or pleural empyema, such as dyspnea, chest pain or persistent cough. Early diagnosis and treatment are essential to prevent complications and ensure a favorable prognosis.
Appointments and consultations at Elytis
For diagnosis and treatment of pleural conditions, schedule a consultation with our thoracic surgery specialists. Elytis offers you the highest standards of care for your lung health.
Feel free to contact us to find out more about our services and to schedule a consultation.
Latest medical review:
03.04.2025, Dr. Lovin Ciprian Sebastian Ciprian - Primary Physician
