Abstract
Pleural disorders are a common reason for referral to respiratory specialists, with over 50 known conditions that can cause pleural effusion. Chest radiography remains the initial investigation of choice, as it can detect pneumothorax, pleural thickening, asbestos-related pleural disorders, and pleural effusion of at least 200 ml in volume. Pneumothorax is defined as the presence of air in the pleural cavity and is a common medical emergency. Common causes of exudative pleural effusions are infection, pulmonary embolism, and malignancy. Mesothelioma is an aggressive form of cancer that is an important cause of mortality worldwide, and arises from the mesothelial cells lining the pleura, usually because of exposure to asbestos fibres. Common causes of transudative pleural effusions include cardiac failure, and liver or renal diseases. Thoracic ultrasound, computed tomography, and positron emission tomography have become important imaging modalities in the investigation of pleural disorders.
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References
Roberts ME, Neville E, Berrisford RG, Antunes G, Ali NJ. Management of a malignant pleural effusion: British Thoracic Society pleural disease guideline 2010. Thorax. 2010;65(Suppl 2):ii32–40.
Hooper C, Lee YC, Maskell N. Investigation of a unilateral pleural effusion in adults: British Thoracic Society pleural disease guideline 2010. Thorax. 2010;65(Suppl 2):ii4–17.
Kastelik JA. Management of malignant pleural effusion. Lung. 2013;191:165–75.
Rahman NM, Singanayagam A, Davies HE, Wrightson JM, Mishra EK, Lee YC, et al. Diagnostic accuracy, safety and utilisation of respiratory physician-delivered thoracic ultrasound. Thorax. 2010;65:449–53.
Havelock T, Teoh R, Laws D, Gleeson F. Pleural procedures and thoracic ultrasound: British Thoracic Society pleural disease guideline 2010. Thorax. 2010;65(Suppl 2):ii61–76.
Qureshi NR, Rahman NM, Gleeson FV. Thoracic ultrasound in the diagnosis of malignant pleural effusion. Thorax. 2009;64:139–43.
Maskell NA, Gleeson FV, Davies RJ. Standard pleural biopsy versus CT-guided cutting-needle biopsy for diagnosis of malignant disease in pleural effusions: a randomised controlled trial. Lancet. 2003;361:1326–30.
Rahman NM, Ali NJ, Brown G, Chapman SJ, Davies RJ, Downer NJ, et al. Local anaesthetic thoracoscopy: British Thoracic Society pleural disease guideline 2010. Thorax. 2010;65(Suppl 2):ii54–60.
Dresler CM, Olak J, Herndon JE 2nd, Richards WG, Scalzetti E, Fleishman SB, et al. Phase III intergroup study of talc poudrage vs talc slurry sclerosis for malignant pleural effusion. Chest. 2005;127:909–15.
Porcel JM, Madronero AB, Pardina M, Vives M, Esquerda A, Light RW. Analysis of pleural effusions in acute pulmonary embolism: radiological and pleural fluid data from 230 patients. Respirology. 2007;12:234–9.
Light RW, Rogers JT, Cheng D, Rodriguez RM. Large pleural effusions occurring after coronary artery bypass grafting. Ann Intern Med. 1999;130:891–6.
Kastelik JA, Aziz I, Greenstone MA, Thompson R, Morice AH. Pergolide-induced lung disease in patients with Parkinson’s disease. Respir Med. 2002;96:548–50.
Davies HE, Davies RJ, Davies CW. Management of pleural infection in adults: British Thoracic Society pleural disease guideline 2010. Thorax. 2010;65(Suppl 2):ii41–53.
Sahn SA. Diagnosis and management of parapneumonic effusions and empyema. Clin Infect Dis. 2007;45(11):1480–6.
Sahn SA, Iseman MD. Tuberculous empyema. Semin Respir Infect. 1999;14:82–7.
Rahman NM, Maskell NA, West A, Teoh R, Arnold A, Mackinlay C, et al. Intrapleural use of tissue plasminogen activator and DNase in pleural infection. N Engl J Med. 2011;365:518–26.
Rahman NM, Kahan BC, Miller RF, Gleeson FV, Nunn AJ, Maskell NA. A clinical score (RAPID) to identify those at risk for poor outcome at presentation in patients with pleural infection. Chest. 2014;145:848–55.
Van Meter ME, McKee KY, Kohlwes RJ. Efficacy and safety of tunneled pleural catheters in adults with malignant pleural effusions: a systematic review. J Gen Intern Med. 2011;26:70–6.
MacDuff A, Arnold A, Harvey J. Management of spontaneous pneumothorax: British Thoracic Society pleural disease guideline 2010. Thorax. 2010;65(Suppl 2):ii18–31.
Bobbio A, Dechartres A, Bouam S, Damotte D, Rabbat A, Regnard JF, et al. Epidemiology of spontaneous pneumothorax: gender-related differences. Thorax. 2015;70:653–8.
Gordon CE, Feller-Kopman D, Balk EM, Smetana GW. Pneumothorax following thoracentesis: a systematic review and meta-analysis. Arch Intern Med. 2010;170:332–9.
Baumann MH, Strange C, Heffner JE, Light R, Kirby TJ, Klein J, et al. Management of spontaneous pneumothorax: an American College of Chest Physicians Delphi consensus statement. Chest. 2001;119:590–602.
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Kastelik, J.A., Greenstone, M.A., Pathmanathan, S. (2018). Diseases of the Pleura. In: Hart, S., Greenstone, M. (eds) Foundations of Respiratory Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-94127-1_7
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DOI: https://doi.org/10.1007/978-3-319-94127-1_7
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