Disease of the Pleura

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Disease of the Pleura
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Pleurisy

• It is not a specific disease but indicates
  involvement of the pleura by underlying disease
  resulting in pleuritis.
• Typically resulting in pleuritic chest pain
• Pleural rub can be auscultated
• Common due to lung infection (pneumonia),
  infarction, or extension of tumor

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Pleural Effusion

• Accumulation of fluid in the pleural cavity
• Usually is asymptomatic unless severe and causing
  compression of lung and Dyspnea
• Exudate (protein gt 30g/L) or Transudate (protein
  lt 30g/L)
• Cells neutorphils, lymphocytes, malignant cells

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Causes of pleural effusion

• Increase hydrostatic pressure heart failure,
  renal failure, volume overload, Na retention
• Decrease osmotic pressure liver failure,
  cirrhosis, nephrotic syndrome, hypoalbuminemia,
  malnutrition
• Inflammation infection (pneumonia), lung
  infarction, SLE, rheumatoid arthritis
• Lymphatic obstruction
• Malignancy

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Empyema

• Pus in the pleura
• Commonly due to infection, spread from pneumonia
  and TB.

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Spontanous Penumothorax

• Air in the pleural cavity
• Communication of pleura to lungs
• Commonly due to rupture of subpleural bulla or
  rupture of abscess or TB
• Present as sudden chest pain and dyspnea
• Shift of trachea to the opposite side
• Sings of air in the pleural cavity

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Spontanous Penumothorax

• Closed pneumothorax communication between pleura
  and lung seals off, and the air is gradually
  absorbed
• Open pneumothorax The communication between lung
  and pleura is continuous (usually open into a
  bronchus) resulting in collapse of lung
• Tension pneumothorax one-way valve
  communication, resulting in air passing to the
  pleura but not back to lungs, results in large
  pneumothorax

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