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whats the treatment for undiagnosed bilateral plueral effusion?

By April 5, 2010 - 5:21pm
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my father is getting bilateral plueral effusion siz months ago, Drs did thoarcentesis and all other kind of test,CT and all.But they could not find any thing. Now after six months he got the effusion back and repeat all the test. but unable to diagnose any thing. could any one help here.

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Expert HERWriter Guide Blogger

Hi sheikh - Thanks for your question and welcome to EmpowHER.

Pleural disorders affect the pleura, which is a large, thin sheet or membrane of tissue that is wrapped around the outside of the lungs and lines the inside of the chest cavity. Pleural effusion occurs when there is an abnormal build up of fluid in the pleural space. If the pleural tissues are already inflamed then the fluid will help alleviate the pain associated with the tissues rubbing against each other. But too much fluid can force the layer closest to the lungs against the lungs. Continual build up of fluid and pressure against the lung can cause it to collapse, resulting in difficulty breathing.

The causes include infections, injuries, heart or liver failure, blood clots in the blood vessels of the lungs (pulmonary emboli), cancer, pneumonia, and medications. All of these can cause the build up of fluid. Has your father's doctor asked questions about these causes or explained these causes?

Diagnostic methods usually include chest X-rays, laboratory testing of the fluid (thoracentesis), and a CT scan. The X-rays show the particular areas that are affected by the inflammation. The laboratory testing is needed to determine what kind of fluid has built up and the presence of any bacteria. If there is bacteria build up, the laboratory tests will show what kind of bacteria so the proper antibiotics may be administered. This fluid will also be examined for the amount and types of cells, and for the presence of cancer cells.

Other diagnostic tools include the use of a thoracoscope, which is a tube that when inserted into the chest cavity allows the doctor to visually examine the pleural space and obtain tissue samples. Thoracoscopy can also detect cancer and tuberculosis.

A needle biopsy may be indicated if the equipment for a thoracoscopy is not available. This involves inserting a needle through the chest wall to withdraw a sample of the fluid that has built up. Occasionally, doctors will need to directly view the airways through a viewing tube in a procedure known as a "bronchoscopy" to help them determine the cause of the fluid build up.

Treatment of larger infections usually consists of inserting a tube into the chest draining the fluid off, which will relieve the shortness of breath. This is usually done through thoracentesis, which your father had six months ago. Up to 1.5 liters (1.5 quarts) of fluid at a time can be drained using this procedure.

Smaller cases of pleural effusion sometimes may not be treated at all, but doctors typically investigate what caused the effusion in the first place, and that will likely be the target of treatment. Could this be what is happening with your dad?

I hope this information helps you. Also, I'm not sure I fully understand your question. Are you saying your dad has been treated once for pleural effusion and that it has returned but he's not being treated this time? Or are you saying that he's developed a new problem and has not been given a diagnosis?

The more we understand your situation the more we can help.
Take care, Pat

April 5, 2010 - 6:08pm
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