Pleural effusions: Evaluation and management REVIEW

Treatment depends on the severity and the cause. Thoracentesis is done to relieve symptoms. Chest tubes provide continuous drainage in cases of pneumothorax, hemothorax, penetrating chest trauma, complicated parapneumonic effusion or empyema, or chylothorax. Pleural sclerosis (pleurodesis) is usually indicated for patients with uncontrolled symptomatic malignant effusions. ANY CONDITIONS can cause pleural effusions, including diseases that are local (in the lungs or pleura), extrapulmonic, or systemic. In many cases the cause is a chronic condition for which the patient is already receiving treatment; therefore, a patient with pleural effusion may present to a pulmonologist—or to a general internist, other medical specialist, or surgeon. In up to 20% of cases the cause remains unknown despite a diagnostic workup.