Pleural fluid collections and ultrasound guided percutaneous drainage

Department of Surgery and Oncology, Operative Unit of General and Thoracic Surgery, University of Palermo, Palermo, Italy.
Annali italiani di chirurgia (Impact Factor: 0.6). 11/2010; 81(6):429-32.
Source: PubMed


The presence of fluid collection in the pleural cavity is a frequent clinical problem that requires drainage for diagnostic and therapeutic purposes. Aim of our study is the retrospective evaluation of our experience in diagnostic and therapeutic thoracic drainage, to stress the cause of failure and to emphasise the cost-effectiveness of the technique.
From January 1995 to May 2009, 564 therapeutic and diagnostic ultrasound (US) guided percutaneous drainages of pleural fluid collection were performed in 412 patients.
The macroscopic, biochemical, cytological and microbiological examination of the drained fluid diagnosed the presence of 80 (19.4%) transudates, 101 (24.5%) non neoplastic exudates, 55 (13.4%) neoplastic exudates, 152 (36.9%) empyema and 24 (5.8%) haemothorax. There were no major complications. Minor complications were present in 23/564 cases (4.0%).
The US guided puncture of the pleural fluid collection allows a high rate of success (in correct detection and drainage of chronic pleural effusions), reduces the rate of complications and is well accepted by patients.

Download full-text


Available from: Girolamo Geraci
  • [Show abstract] [Hide abstract]
    ABSTRACT: Pneumonia is the most frequent cause of pleural effusion in children. In recent years, changes in the epidemiological pattern have been observed, with an increase of complications and rate of admissions. Microbiological changes have been also described, such as types of bacteria and serotypes implicated, which can be related to different antibiotic policy and immunisation schedule. No conclusive guidelines have been published for pediatric population regarding the management of parapneumonic pleural effusion. Therefore, we reviewed this topic based on Sociedad Española de Neumología Pediátrica (Spanish Society of Pediatric Pulmonology) recommendations and a review of the existing literature. Treatment should be based on early diagnosis and propper intravenous antibiotic use. Pleural effusion management includes different procedures such as pleural drainage (with or without fibrinolytics), thoracoscopy and thoracotomy, depending on the presence of complications and the evolutive stage.
    No preview · Article · Mar 2012 · Revista española de pediatría