Disorders of Pleura

Disorders of Pleura

Pleurisy:
Chest pain from stimulation of pain fibres in parietal pleura, associated with inflammation of pleural lining. Many disease processes can cause pleuritic pain

Clinical features – pain on breathing, stabbing or shooting chest pain,

Management – treatment of underlying disorder

Pleural Effusion:
Accumulation of an abnormal amount of serous fluid in the pleural space.

Common causes – pneumonia, tuberculosis, pulmonary infarction, malignancy, cardiac failure, connective tissue disease.

Clinical features – may be asymptomatic; dyspnoea (if large); pleuritic chest pain (if small);

Management – aspiration if associated with breathlessness; treatment of underlying cause

Empyema:
Pus accumulation in pleural space.
Secondary to infection in nearby structure (usually lung)

Pneumothorax:
Accumulation of air in pleural space

Aetiology – often spontaneous (especially young thin males) due to a rupture of a pleural bleb; trauma; asthma; COPD; cystic fibrosis; sarcoidosis; fibrosing alveolitis

Clinical features – usually sudden onset – pain or feeling of tightness aggravated by breathing  breathlessness and if severe  cyanosis

Management - drains