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Chapter 39. Pleural Disorders

Michael H Baumann, MD, MS, FCCP
DOI: 10.1378/pulm.26.39
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Synopsis 

Pleural disorders are common and present ongoing management challenges. This chapter will review the pathophysiology of pleural fluid formation and practical aspects of thoracentesis and pleural fluid evaluation. Various imaging tools and invasive diagnostic/therapeutic tools will be reviewed and their optimal applications delineated. An emphasis on the diagnosis and management of the most common causes of transudative and exudative effusions will be featured, with several uncommon causes highlighted briefly. Lastly, the management of spontaneous and iatrogenic pneumothoraces will be described.

Objectives 
  • Describe the pathophysiology of pleural fluid formation.

  • Describe practical aspects of thoracentesis and pleural fluid analysis including pleural fluid interpretation.

  • Describe the roles and limitations of various imaging tools in pleural disease.

  • Describe the roles and limitations of invasive diagnostic and therapeutic tools in pleural disease.

  • Describe the pathogenesis, clinical features, and management of patients with the most common causes of transudative and exudative pleural effusions.

  • Describe the pathogenesis and management of patients with spontaneous and iatrogenic pneumothoraces.

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