Cardiovascular and Interventional Radiological Society of Europe

Pleural effusion


Pleural effusion is the collection of excessive amounts of fluid in the envelope-like space that surrounds the lungs (called the pleural cavity). The characteristics and thickness of the effusion depend on the origin of the fluid and the cause of the build-up.


In many cases, there are no obvious symptoms. However, if there is a large amount of fluid or there is an inflammation, you may notice symptoms such as shortness of breath, chest pain, cough and fever.


To diagnose you, a doctor will first physically examine you with a stethoscope, or use a technique called percussion (tapping body parts with fingers, hands or small instruments). The doctor can usually diagnose the condition by taking a chest X-ray, with pleural effusions appearing as a white zone at the base of the lung. Other imaging techniques can be used to provide further information.


The exact treatment will depend on the cause of the effusion, and on whether or not you are experiencing any symptoms. The doctor may remove some of the fluid by inserting a needle attached to a syringe into the area above your rib, in a procedure called aspiration. This is done both to investigate the cause of the effusion and to relieve the symptoms it triggers. If the effusion is large or infected, the doctor may insert a tube into the pleural space to drain it, using image guidance to properly place the tube. This should relieve your symptoms and prevent complications.

If you regularly suffer from effusions, it may be necessary to undergo a procedure called pleurodesis, which can either be carried out using chemicals in the pleural space or through surgery. If pleurodesis fails, you may need a treatment called pleural decortication, which involves surgically removing the problematic layer of fibrous tissue.