Pleural Disease

“Pleurisy” is a term that describes pain coming from the lining of the inside of the chest. There are many causes of pleurisy and patients may not only have pain, but shortness of breath.

“Pleural effusion” is the abnormal accumulation of fluid around the lung. The causes of pleurisy and pleural effusion may include: infections, cancers, inflammatory diseases (rheumatoid arthritis, lupus, etc.), reactions to certain medications, and trauma.

At GPA, we perform ultrasound-guided thoracentesis which allows us to safely sample the fluid around the lung. For patients who need a more advanced diagnostic procedure, both Dr. Fields and Dr. deKeratry perform medical thoracoscopy. Medical thoracoscopy (MTx) is an interventional pulmonology procedure that is performed under sedation in our local affiliate hospital(s). It is a minimally invasive chest surgery that allows direct visualization of the inside of the chest lining and lung.

For patients who have been diagnosed with cancer-related pleural effusions, we offer therapeutic MTx with a procedure called “talc pleurodesis” to help prevent the re-accumulation of fluid. Additionally, we also offer cryo-ablation therapy with the intention of debulking tumor burden in the pleural space. Cryo-ablation in the pleura is intended to complement additional cancer treatment modalities provided by the patient’s medical or radiation oncologist.

For patients who may not be candidates for the MTx, alternatives for management of their pleural fluid include placement of a tunneled pleural drain – “Pleur-x”.

We also treat primary and secondary pneumothoraces (collapsed lung) with a variety of different techniques listed here: