Effuutiot

Effuutiot, or effusions, are abnormal accumulations of fluid within a body cavity, tissue space, or joint. They commonly reflect an imbalance between fluid production and drainage and may arise from injury, inflammation, infection, or systemic disease. The most frequently encountered sites are the pleural space around the lungs, the pericardial sac around the heart, the peritoneal cavity in the abdomen (ascites), and joints.

Pleural effusions can be classified as transudates or exudates based on fluid chemistry; transudates arise from systemic factors such as heart failure or cirrhosis, while exudates reflect local inflammation or malignancy. Similar distinctions apply to other cavity effusions. Accumulation in joints is usually called a joint effusion and is often due to inflammatory arthritis or infection.

Common causes include congestive heart failure, hepatic cirrhosis with portal hypertension, nephrotic syndrome, infections, malignancies, inflammatory diseases, pancreatitis, and venous obstruction. Pericardial effusion can accompany infection, inflammatory disease, hypothyroidism, kidney failure, or cancer.

Evaluation combines history and exam with imaging (chest X-ray or ultrasound for pleural, echocardiography for pericardial, ultrasound for ascites) and sampling of the fluid. Pleural effusion fluid is analyzed for protein, LDH, cell count, Gram stain/culture, and cytology; Light's criteria help distinguish transudate from exudate. Ascitic fluid is analyzed with serum-ascites albumin gradient (SAAG), total protein, and cell counts. Pericardial fluid analysis includes similar chemistry and cytology.

Treatment targets the underlying cause and may provide symptomatic relief. Diuretics for fluid overload; therapeutic drainage by thoracentesis, paracentesis, or pericardiocentesis as needed; management of infection with antibiotics; anti-inflammatory or immunosuppressive therapy for inflammatory diseases; in malignant effusions, palliative drainage and tumor-directed therapy. Prognosis depends on cause and severity; some effusions resolve with treatment, others signal advanced disease.