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Q. My CT thorax shows moderate right pleural effusion. Should it be drained immediately?

Answered by
Dr. Sadaf Mustafa
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jan 25, 2020

Hello doctor,

A recent non-contrast CT scan of thorax, taken 10 weeks after undergoing a right hemicolectomy, showed:

1. Expansible sclerotic lesion in right rib may be benign. Bone scan might be useful.

Given that I have only one kidney left, how would the injection of radioactive substances affect my single kidney?

2. Moderate right pleural effusion. What are the risks of draining this effusion? What natural alternatives are there (home remedies)? How urgent is it to drain this moderate effusion?

I have right pleural effusion, no chest pain, but some shortness of breath especially when climbing stairs.

#

Hello,

Welcome to icliniq.com.

To answer your first question, it all depends upon your creatinine clearance (how good is the remaining kidney functioning), also the reason why one would want to investigate this lesion further. Say for example if I am concerned about a metastatic lesion I would consider a PET-CT (positron emission tomography-computed tomography) if I am worried about a primary bone cancer an MRI and so forth.

Moderate pleural effusion in a diagnosed condition is treated by watching closely and making sure that it is improving by serial chest x-rays. However, if it is a new onset of pleural effusion then it should be drained and the pathology should be investigated. Salt restriction in a patient with heart failure, liver and kidney issues helps to improve the pleural effusion.

I hope this helps.

Thank you doctor,

One of my kidney was removed before five years. My remaining kidney has been functioning well ever since. A PET or a CT with contrast both could affect my remaining kidney, which is why I declared myself allergic to infusion of any kind of dye. If I choose not to go for a bone scan, what would you suggest is the best way to monitor or follow up?

Thanks for your suggestion of serial chest x-rays. What do you mean by a new onset pleural effusion? It has just been discovered because an MRI I underwent prior to my surgery, did not reveal it, since the MRI was on the abdomen. Salt restriction i.e. complete avoidance has been practiced for long. What other home remedies do you recommend? (garlic, turmeric, ginger, honey, caraway seeds, etc.

#

Hello,

Welcome back to icliniq.com.

Since you have a sclerotic lesion, it would be nice to know if you have any other similar lesions. You can have a skeletal survey which are a series of bone x-rays to look for similar lesions. Now looking for this particular lesion perhaps we can get an MRI without contrast.

Sorry, I should have been more clear, by new onset I wanted to say if this is the first time you ever had a pleural effusion. To my knowledge and understanding, no home remedies work that good. You have the effusion since four months, I personally believe it should be looked into. My recommendation would be getting a small sample and checking the pathology as to why it is happening. My impression is that you are not a cardiac patient and have normal liver and kidney functions.

Thank you doctor,

If in the future I want to consult you again how to assure that my queries are addressed to you?

#

Hello,

Welcome back to icliniq.com.

You will have to go on icliniq website or app, put my full name and propose a question directly to me.


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