What Is the Thoracic Diaphragm?

Pleural adhesions refer to the adhesion of two layers of pleura. It is caused by tuberculosis, pleurisy, and chest injury. Because these patients often have exudate fluid in the pleural cavity, once the fibrin in the effusion deposits on the pleura, it can lead to pleural thickening, can also cause pleural thickening and even adhesion. Pleural adhesions are a stubborn disease that should be prevented. Use antibacterial or anti-inflammatory drugs or surgery. Traditional Chinese medicine is mainly for promoting blood circulation and removing blood stasis, regulating qi and clearing collaterals, and relieving pain.

Basic Information

English name

Pleura Adhesions

Visiting department

Thoracic surgery

Common locations

pleura

Common causes

Caused by tuberculosis, pleurisy, chest injury, etc.

Common symptoms

Two layers of pleura stick together

Causes of pleural adhesions and common diseases

1. Blood in the chest (blood chest)

Usually caused by chest injury.

2. Pulmonary empyema (empyema)

Can be caused by pneumonia or lung abscess spread to the chest cavity.

3. Intraluminal chyloid accumulation (chylochest)

It is caused by damage to the main lymphatic vessels (thoracic ducts) in the chest cavity or tumor blocking the ducts.

4. Fluke disease

The lungs are mainly characterized by infiltration, cyst nodules, and indurated nodules, but thickened pleural adhesions can also be found; chest x-rays and CT scans of pneumonia pseudotumor, a few can also have pleural adhesions.

5. Late silicosis

Due to the contraction, traction and adhesion of the fibrous tissue in the lungs, the diaphragm can present a "sky-like" image, showing pleural adhesions at the base of the lung.

6. Accumulation of high cholesterol fluid in the chest

Occurs in certain chronic pleural effusions, such as tuberculosis or rheumatoid arthritis (more than half of the autopsy has adhesive pleurisy, which is common in patients with severe advanced disease).

7. Other

Malignant pleural effusion, spontaneous pneumothorax, recurrent non-malignant pleural effusion, injecting pleural adhesion agents, such as doxycycline solution or talc, into the pleural cavity, causing the two layers of pleura to adhere to each other, eliminating the space for fluid and air accumulation .

Pleural adhesion test

Thoracic fluoroscopy and CT scan if necessary.

Differential diagnosis of pleural adhesions

Pleural thickening is first caused by pleurisy. Some are more than 2 cm in length and are composed of fibrous connective tissue. They are grayish white and have granulation tissue on the surface. There are a large amount of necrotic tissue and pus in the pus cavity and there are two types of pleurisy. One is dry pleurisy (no pleural effusion ), The other is exudative pleurisy (with pleural effusion). The main cause of pleural hypertrophy is the second type of pleurisy. Due to the lack of timely detection and pumping treatment of pleural fluid, the pleural fluid stays in the pleural cavity for a long time. The pleural fluid stimulates the pleura and the fibrin in the pleural fluid is attached to the chest wall, which makes the pleural hyperplasia thick.

Principles of pleural adhesion treatment

Pleural adhesions are a persistent disease. Should be based on prevention, use antibacterial anti-inflammatory drugs to control the development of inflammation, if adhesions have formed prominent symptoms, surgery can be performed to loosen adhesions. However, the effects of both methods are not satisfactory to both the doctor and the patient, especially the surgical treatment. Not only is the patient painful, but it is also easy to cause new pleural adhesion and pleural calcification. Traditional Chinese medicine is mainly for promoting blood circulation and removing blood stasis, regulating qi and clearing collaterals, and relieving pain.