Munson Health
Pleural Effusion

Back to Document

by Badash M

(Water on the Lungs)



Effusion is usually caused by disease or injury.
Transudative effusion may be caused by:
Exudative effusion may be caused by:
  • Tuberculosis
  • Pneumonia and other lung infections
  • Rheumatic disease, such as sarcoidosis
  • Anti-inflammatory diseases, such as Lupus
  • Cancer, especially of the lung, breast, or lymph system
  • Blood clot formation in the lung


Treatment is usually aimed at treating the underlying cause. This may include medications or surgery.
Your doctor may take a "watchful waiting" approach if your symptoms are minor. You will be monitored until the effusion is gone.

Drain the Pleural Effusion

The pleural effusion may be drained by:
  • Therapeutic thoracentesis—a needle is inserted into the area to withdraw excess fluid.
  • Tube thoracostomy—a tube is placed in the side of your chest to allow fluid to drain. It will be left in place for several days.

Seal the Pleural Layers

The doctor may recommend chemical pleurodesis. During this procedure, talc powder or an irritating chemical is injected into the pleural space. This will permanently seal the two layers of the pleura together. The seal may help prevent further fluid buildup.
Radiation therapy may also be used to seal the pleura.


In severe cases, surgery may be needed. Some of the pleura will be removed during surgery. Suregery options may include:
  • Thoracotomy—traditional, open chest procedure
  • Video-assisted thorascopic surgery (VATS)—minimally-invasive surgery that only requires small keyhole size incisions


American Lung Association

National Heart, Lung, and Blood Institute



The Canadian Lung Association

Health Canada



Drug-induced pulmonary disease. Merck Manual for Health Care Professionals. Available at: . Updated May 2008. Accessed March 3, 2013.

Pleural effusion. Remedy's Health Communities website. Available at: . Updated June 1, 2000. Accessed March 5, 2013.

Pleural effusion-diagnostic evaluation. EBSCO DynaMed website. Available at: . Updated December 8, 2012. Accessed February 24, 2013.

Pleural effusion - differential diagnosis. EBSCO DynaMed website. Available at: . Updated December 8, 2012. Accessed February 24, 2013

Pleurisy and other pleural disorders. National Heart, Lung, and Blood Institute website. Available at: . Updated September 21, 2011. Accessed March 5, 2013.

12/10/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Roberts M, Neville E, Berrisford R, Atunes G, Ali N. Management of a malignant pleural effusion: British Thoracic Society pleural disease guideline 2010. Thorax . 2010;65 Suppl 2:ii32.


Revision Information