PLEURAL EFFUSION AND PLEURAL TAPPING

PLEURAL EFFUSION AND PLEURAL TAPPING

Pleurisy or pleural effusion is the accumulation of fluid in the pleural cavity.

1. Anatomy of Pleural Cavity

   • Pleural cavity is a thin space between two pleura layers that encloses the lungs.
   • The visceral pleura adheres to the lung surface.
   • The parietal pleura is attached to the inner surface of the thoracic wall.

2. Clinical Importance

   • The pleural cavity is filled with a small amount of serous fluid that prevents friction between the lung and thoracic wall.
   • Pleural effusion can cause respiratory distress, cough, and chest pain.

3. Causes of Pleural Effusion

   • Infections (pneumonia, tuberculous pleurisy, empyema)
   • Malignancies (breast, lung, ovarian cancers)
   • Cirrhosis of the liver
   • Congestive heart failure
   • Pancreatitis
   • Pulmonary embolism
   • Trauma
   • Tuberculosis

4. Indications of Pleural Tapping

   • Large pleural effusion with respiratory distress
   • Infection or malignancy in the pleural cavity
   • Diagnostic purposes

5. Contraindications of Pleural Tapping

   • Coagulopathy or bleeding tendency
   • Low platelet count
   • High risk of bleeding
   • Thoracic spine injuries

6. Complications of Pleural Tapping

   • Bleeding or hematoma
   • Infection
   • Pneumothorax
   • Cardiac tamponade

7. Interpretation of Pleural Fluid Findings

   • Appearance (clear or turbid)
   • Volume (small or large)
   • Protein content
   • Lactate dehydrogenase
   • Glucose level
   • pH
   • Adenosine deaminase
   • Tumor markers

8. Pathology of Pleural Effusion

   • Transudate: clear fluid with low protein content
   • Exudate: turbid fluid with high protein content

9. Types of Pleural Effusion

   • Cardiac transudate
   • Renal transudate
   • Nephrotic syndrome transudate
   • Pulmonary embolism exudate
   • Malignant exudate
   • Tuberculous exudate
   • Empyema

10. Homoeopathic Management of Pleural Effusion

    • Arnica Montana: inflammation and pain
    • Aconitum Napellus: acute pleurisy
    • Belladonna: inflammation and fever
    • Bryonia Alba: cough and chest pain
    • Phosphorus: inflammation and fluid accumulation
    • Silica: chronic pleurisy
    • Spongia Tosta: cough and shortness of breath

Pleural Tapping Procedure:

1 → Insertion of the needle into the skin 2 → Puncture of the parietal pleura 3 → Withdrawal of fluid 4 → Closure of the tract with a small suture