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Pleural Effusion

Over the last few decades, research into asbestos has shown us just how insidious and dangerous it can be. Asbestos has destroyed families, and adversely affected the lives of many people. When people think of asbestos related illnesses, pleural effusion is one of the lesser known complications. Whilst straightforward to treat on its own, it can be truly debilitating and could be the first sign that you may be suffering from something far more serious. Pleural effusion can be a warning sign that you may be affected by a pulmonary embolism, congestive heart failure, mesothelioma or even cancer.

Overexposure to asbestos is a leading cause in pleural effusion related conditions such as mesothelioma or lung cancer. The percentage of pleural effusions which contain cancer cells or signs of tumours is uncomfortably high, and with up to 15% of sufferers showing few symptoms, early detection is key. If you, or your loved ones, are at a high risk of asbestos-related illness please keep an eye out for any symptoms and go to your local GP if you believe anything is amiss.

Pleural effusion is, simply put, excess fluid around the lungs. This fluid builds up within the pleural space between the lining around your lungs and the chest cavity. Although some fluid in the pleural space is healthy for the lungs, too much can cause painful symptoms and have a severe impact on your quality of life.

Someone with pleural effusion may experience side effects such as:

  • Fever
  • Dry cough
  • Pleurisy
  • Orthopnea – Chest pain brought on whilst breathing deeply, often made worse whilst lying down.
  • Shortness of breath
  • Persistent hiccups
  • Difficulty with physical exercise

These symptoms will often start out as very mild and grow worse over time. If left untreated, pleural effusion can lead to greater complications and could even be fatal.

If your doctor suspects that you may be suffering from a pleural effusion, they will use a stethoscope and tap your chest to discern any signs of excess fluid within the layers of the pleura. If necessary your doctor may order additional tests which may include a chest x-ray, CT scan, or an ultrasound. All these tests are completely painless and will help discern whether there are any underlying causes.

If a small amount of fluid is confirmed and your pleural effusion is believed to be exudative in nature, your doctor may choose to complete a diagnostic thoracentesis. Here, a small tube or needle may be inserted into the chest wall to extract a sample of the fluid. This will then be sent off for further testing and will let your doctor know if your pleural effusion could be pneumonia, a symptom of cancer, or any number of other underlying causes.

There are two kinds of pleural effusion: transudative and exudative.

Transudative pleural effusion is diagnosed when the excess fluid inside of the chest wall is found to be similar to normal fluid from the pleural space. The most common cause for transudative pleural effusion is congestive heart failure. Transudative is much easier to treat and will often not need to be drained, as this is only necessary when the excess fluid grows too large.

However, exudative is far more dangerous. Commonly caused by lung cancer or pneumonia, exudative pleural effusion occurs when fluid (and even bacteria) leaks through the blood vessels into the layers of the pleura. This type of pleural effusion is highly likely to require drainage and is often more difficult to treat. In most cases, people suffering from asbestos related illnesses will experience pleural effusions that are exudative in nature.

Pleural effusions, when diagnosed early, have straightforward treatment options. The most common treatment will often be a thoracentesis. A tube will be inserted, and the excess fluid will be drained away. This will also provide an opportunity for your doctor to complete further diagnostic tests. This treatment should alleviate symptoms quickly, however, many patients may have to have it performed multiple times as pleural effusion can often be a recurring illness.

If you continue to suffer with pleural effusions, doctors may try other procedures such as pleurodesis, pleural decortication, a pleural drain or a tube thoracostomy.

During both a tube thoracostomy and pleurodesis, you doctor will make a small incision in your chest wall and insert a small plastic chest tube, this is where the two procedures will differ. If you are undergoing a thoracostomy, the tube will be left in place for several days, allowing the excess fluid to drain.

When a pleurodesis is performed, doctors will inject a (substance) sterile talc directly into your pleural space which will irritate and inflame the pleura. This will then allow the chest wall and pleura to heal, closing the gap caused by excess fluid. This procedure will usually take between 24 and 48 hours before the chest tube can be safely removed.

A pleural drain works a little differently. If you are suffering from continuous bouts of pleural effusion, a pleural drain can be a very effective long-term treatment which will allow you to drain the fluid by yourself at home. A doctor will place a catheter through your chest wall and into the pleural space, you will then be taught how and when you can drain the fluid yourself should your symptoms reappear, and the fluid build-up become excessive.

If your doctor decides a more aggressive course of treatment is necessary, you may require pleural decortication. Pleural decortication is a surgical operation, in which the surgeon will make an incision into your chest cavity and directly remove any dangerous inflammation or tissue. Any cancer cells or visible tumour growth will be scraped away. Patients will usually be required to spend a minimum of about one week at the hospital following surgery, however, it will usually take several weeks before a patient is fully recovered.

A diagnosis of pleural effusion can be frightening, but with early detection and continued check-ups, symptoms can be properly managed and relieved quickly. If your pleural effusions have been caused due to an asbestos related ailment, you could be liable for compensation. If this is something you would like to pursue, our team of experienced and accredited personal injury specialists will be able to help.

For further information contact us on our free-phone number 0808 164 6018 or email us at