What Is Pleurisy

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What Is Pleurisy and Other Disorders of the Pleura?

 

Pleurisy (PLUR-is-see) is inflammation (swelling) of the pleura. The pleura is

alarge, thin sheet of tissue (membrane) that wraps around the outside of your

lungs and lines the inside of your chest cavity.

 

Between the layer of the pleura that wraps around your lungs and the layer that

lines your chest cavity is a very thin space. This is called the pleural space.

Normally it's filled with a small amount of fluid—about 4 teaspoons full. The

fluid helps the two layers of the pleura glide smoothly past each other as your

lungs breathe air in and out.

 

Pleurisy occurs when the two layers of the pleura become red and inflamed. Then

they rub against each other every time your lungs expand to breathe in air. This

can cause sharp pain with breathing. Infections like pneumonia are the most

common cause of swelling, or inflammation, of the pleura and pleurisy.

 

Other Disorders of the Pleura

 

Pleural Effusion

 

In some cases of pleurisy, excess fluid builds up in the pleural space. This is

called a pleural effusion. The buildup of fluid usually forces the two layers of

the pleura apart so they don't rub against each other when you breathe. This can

relieve your pain. However, a large amount of extra fluid can push the

pleura against your lung until the lung, or a part of it, collapses. This can

make it hard for you to breathe. In some cases of pleural effusion, the extra

fluid gets infected and turns into an abscess. This is called an empyema

(em-pi-E-ma).

 

Pneumothorax

 

Air or gas also can build up in the pleural space. This is called a

pneumothorax (noo-mo-THOR-aks). It can result from acute lung injury or a lung

disease like emphysema. Lung procedures, like surgery, drainage of fluid with a

needle, examination of the lung from the inside with a light and a camera, or

mechanical ventilation, also can cause it.

 

The most common symptom is sudden pain in one side of the lung and shortness of

breath. A pneumothorax also can put pressure on the lung and cause it to

collapse. If the pneumothorax is small, it may go away on its own. If it's

large, you may need to have a tube placed through your skin and chest wall into

the pleural space to remove the air.

 

If the pneumothorax is small, it may go away on its own. If it's large, you may

need to have a tube placed through your skin and chest wall into the pleural

space to remove the air.

 

The symptoms of pneumothorax include:

-Sudden, sharp chest pain that gets worse when you breathe in deeply or cough

-Shortness of breath

-Chest tightness

-Easy fatigue (tiredness)

-A rapid heart rate

-A bluish color of the skin caused by lack of oxygen

 

 

 

Hemothorax (he-mo-THOR-aks)

 

The most common cause is injury to your chest from blunt force or chest or heart

surgery. Hemothorax also can occur in people with lung or pleural cancer.

Hemothorax can put pressure on the lung and force it to collapse. It also can

cause shock, a state in which not enough blood and oxygen reach important organs

in the body.  

 

What Are the Signs and Symptoms of Pleurisy and Other Disorders of the Pleura?

 

The main symptom of pleurisy is a sharp or stabbing pain in your chest that gets

worse when you breathe in deeply or cough or sneeze. The pain may stay in one

place or it may spread to your shoulder or back. Sometimes it becomes a fairly

constant dull ache. Depending on what is causing the pleurisy, you may have

other symptoms, such as:

 

-Shortness of breath

-Fever and chills

-Shallow breathing

-Unexplained weight loss

-A sore throat followed by pain and swelling in your joints

 

 

How Are Pleurisy and Other Disorders of the Pleura Treated?

 

The goals of treatment are to:

-Remove the fluid, air, or blood from the pleural space

-Relieve symptoms

-Treat the underlying condition

-If large amounts of fluid, air, or blood aren't removed from the pleural space,

they may put pressure on your lung and cause it to

collapse.

 

Relieve Symptoms

For relief of pleurisy symptoms, your doctor may recommend:

-Acetaminophen or anti-inflammatory agents, such as ibuprofen, to control pain.

-Codeine-based cough syrups to control a cough.

-Lying on the painful side. This may make you more comfortable.

-Breathing deeply and coughing to clear mucus as the pain eases. Otherwise, you

may develop pneumonia.

-Getting plenty of rest.

 

The procedures used to drain fluid, air, or blood from the pleural space are

similar. During thoracentesis, the doctor inserts a needle or a thin, hollow,

plastic tube through the ribs in the back of your chest into your chest wall. A

syringe is attached to draw fluid out of your chest. This procedure can remove

more than 6 cups of fluid at a time. When larger amounts of fluid must be

removed, a chest tube may be inserted through your chest wall. The doctor

injects a local painkiller into the area of your chest wall outside where the

fluid is. He or she will then insert a plastic tube into your chest between two

ribs. The tube is connected to a box that suctions the fluid out.

 

A chest x ray is taken to check the tube's position. A chest tube also is used

to drain blood and air from the pleural space. This can take several days. The

tube is left in place, and you usually stay in the hospital during this time.

Sometimes the fluid contains pus that is very thick or blood clots. Or it may

have formed a hard skin or peel. This makes it harder to drain the fluid. To

help break up the pus or blood clots, the doctor may use the chest tube to put

certain medicines into the pleural space. These medicines are called

fibrinolytics. If the pus or blood clots still don't drain out, you may need

surgery.