Tuesday 28 November 2023
Pleurisy,Pleural effusion,Pneumothorax

Among the chest wall and lungs is a thin membrane which is called the pleural (Fig. 1). This consists of 2 parts (petals):

; An internal (Visceral pleural) covering the lungs

, And an external (pleural toichomatikos) covering the chest wall

The 2 pleural petals forming a cavity between them which contains a small amount of fluid (pleural fluid), which under normal circumstances is less than 1ml. This liquid acts as a lubricant (to avoid friction between the petals of the pleura in respiratory movements).

Fig 1

Increasing this amount of pleural fluid, which occurs only in pathological conditions, called: pleural effusion or pleurisy wet (fig.2), and any inflammation of the pleura without increasing the liquid is called: dry pleurisy.

The pleural fluid can be only one half thorax or both (bilateral pleural effusion).

The collection of blood: aimothorakas (eg after an injury of the chest wall)

Causes of pleurisy

The causes of increased pleural fluid are numerous. Many diseases of the lungs, heart and other systems, can cause pleurisy. We mention some of the most important of them

; Infections (eg pneumonia)

; Special infections (pch.fymatiosi)




Pulmonary embolism;

; Refmatoedis disease & other interstitial lung disease

Heart disease;

Renal Diseases;

Diseases of the colon;


Poor nutrition;

; After surgery in the chest and abdomen

Diagnostic maneuvers


Pleural biopsy;


Laboratory tests pleural fluid

General CA;


; Stains & Cultures for bacteria



The treatment is proportionate to the cause that has caused, such as antibiotics if caused by pneumonia, the anti-tuberculosis therapy as the cause of tuberculosis or urinate only when the result of heart failure.

If large pleural effusion, which may cause shortness of breath, removed by puncture.

If the production of pleural fluid is rapid (eg in malignant diseases), we can put a special tube drainage with suction and then is "plefrodesia (injection of certain substances into the pleura, which cause adhesions and prevent the development of liquid).

Special suction tube drainage are also required to empyema


The collection of air in the pleural cavity is called: pneumothorax (Fig.3)
Causes of pneumothorax

Depending on the cause of the pneumothorax is divided into:


So call the pneumothorax in the absence of chest wall trauma. This in turn is divided into:

1. primary: air bubbles (sch.4). Mainly healthy young adults

2. secondary: an underlying disease may epiplakoun with pneumothorax (eg COPD, vronch.asthma, tuberculosis, cystic fibrosis, etc.)


Traumatic: after trauma

Iatrogenic: after medical treatment (eg biopsy or puncture the chest)


Several years ago causing artificial pneumothorax to treat tuberculosis technique has been abandoned today.


The main symptom is a sharp stabbing pain in the chest.

In cases where the pneumothorax is large or "live" may be accompanied by shortness of breath.

Diagnosis - Treatment

If the pneumothorax is large, it can be diagnosed even by simply listening, otherwise a simple chest radiograph is sufficient.

The treatment depends on the size. The small pneumothorax absorbed himself and need not be any manipulation. In doubt the patient is under observation for at least 24/oro. Inhalation of Oxygen accelerates absorption.

In cases where the pneumothorax

Is large;

; Is 'live'

Pleural fluid coexist;

, Accompanied by great dyspnoea

, Is small but growing

; For both half thorax rib cage (bilateral)

; Has happened previously in the other half thorax Pneumothorax

should be a drainage tube.

In those cases fails epanekptyxi lung or have frequent relapses, is

; 'Plefrodesia "(as in recurrent pleural effusion) is injected various substances which develop adhesions between the petals of pleural

; Surgical scraping of the pleura: aims to break the bubbles present in the pleural

Questions - Answers

diagnostic puncture of the chest
puncture of the chest to remove a large amount of pleural fluid