Hydrotorax: Causes, Symptoms, Diagnosis, Treatment and Overview

Pleural effusion is caused by many disorders and can be life-threatening.

The symptoms of the hydrothorax or pleural effusion may resemble other respiratory problems, and the diagnosis and treatment depend on the underlying cause.

What is hydrothorax?

A disease or disorder can cause fluid accumulation between the chest cavity and the lungs.

Hydrothorax is an accumulation of fluid in the space between the lungs and the thoracic cavity, called the pleural space. It is also commonly called water in the lung.

The thin membranes called the pleura line to represent both the lung and the thoracic cavity of the body. In healthy lungs, these membranes keep a small amount of fluid between the lungs and chest to prevent friction as the lungs expand and contract during breathing.

Someone with a pleural effusion has too much fluid in the pleural space. People who experience a pleural effusion should seek immediate medical attention, as it can be life-threatening if left untreated.


Pleural effusion is always a secondary disorder that is caused by something else. Many things can cause the pleura to create more fluid than usual.


Some of the most common causes of pleural effusion are other diseases and disorders, which include:

  • Liver or kidney disease: diseases such as cirrhosis can cause fluid to accumulate in the body and leak into the chest.
  • Congestive heart failure: the failure of the heart to pump blood properly can cause an accumulation of fluid in the chest.
  • Autoimmune disorders: disorders such as lupus or rheumatoid arthritis can affect the lungs and create problems with the pleura.
  • Infections: Respiratory infections such as tuberculosis and pneumonia can progress and cause water in the lung.
  • Pulmonary embolism: a blockage in the lung arteries caused by a blood clot that can cause the pleura to generate too much fluid.
  • Cancer: usually lung cancer, although any cancer that has progressed to the lungs or pleura may be the cause.

Complications from specific medical procedures can also trigger a pleural effusion. Open heart surgery is a common cause, but any thorax surgery may also increase the risk of a pleural effusion.

Hydrothorax symptoms

The physical symptoms of a pleural effusion commonly appear when the fluid fills the chest cavity. These symptoms include:

  • Dry and unproductive cough
  • Difficulty breathing, mainly when the person lies down.
  • Fever.
  • Chest pain.
  • Difficulty breathing.

Inability to take deep breaths or pain caused by taking deep breaths.

A person who often experiences hiccups or a hiccup pattern that does not go away may also experience pleural effusion.

Some people do not experience symptoms of pleural effusion at all. They usually discover the fluid in their lungs after a physical examination for an unrelated condition.

The signs and symptoms of pleural effusion can also be confused with other lung disorders. People should schedule an appointment with their doctor immediately if they experience these symptoms.


The diagnosis of pleural effusion is not straightforward since many disorders cause similar symptoms. In the first instance, the doctors will perform a physical examination on the person.

The doctor will listen to the lungs with a stethoscope during the physical examination. They can also touch the chest to hear any liquid signal.

The next step is an imaging test, which may be an x-ray or a CT scan.

On an x-ray, several strokes appear white, and the lung tissue appears black, as can be seen in the x-rays of a person with a pleural effusion case report.

CT scans provide more accurate images for doctors to help determine the underlying cause.

One of the most critical steps in the diagnosis is to determine the type of stroke that the person has. There are two types of effusions: transudate and exudate.


A transudate effusion is usually caused by fluid leakage to the chest due to other disorders that cause an imbalance of pressure in the blood vessels. The fluid in the flow is typically composed of compounds found in the blood plasma.

Exudate effusion:

Exuding spills are more difficult to treat and lead to more severe problems. They are usually caused by inflammatory disorders, such as cancers, infections, and traumatic injuries. They can also be caused by blocked blood or lymph vessels.

Doctors will often take a fluid sample in the pleural space by inserting a needle between the ribs into the pleural space and withdrawing a small amount of fluid.

Liquid samples can help doctors look for signs of infection, protein levels, and cancer cells to determine if the individual has a complicated or uncomplicated pleural effusion.

Fluid in a complicated pleural effusion is likely to show definite signs of inflammation or infection. Complicated pleural effusions require immediate treatment because they can cause serious problems.

A spill without complications creates a fluid that shows no signs of infection or inflammation. Uncomplicated effusions can be milder and are much less likely to cause permanent lung damage.

Doctors can also order other tests to help find the cause of the stroke. These tests may include:

  • Kidney function tests to determine if the kidneys are closing.
  • The liver function tries to detect signs of cirrhosis or insufficiency.
  • Lung biopsy to investigate signs of lung cancer.
  • Bronchoscopy to detect possible respiratory problems and symptoms of tumors.
  • Cardiac ultrasound to see evidence of heart failure.

All these tests help reduce the cause of the pleural effusion and make the treatment as simple as possible.


The fluid will have to be drained from the pleural space so that the doctor will use a needle or a tube.

Treatment for pleural effusion depends on the disorder in the body that is causing it. In addition to treating the condition causing the flow, the doctors will drain the fluid from the chest in most cases.

Drained of the chest:

Breast drainage is done by inserting a needle or tube into the pleural space and draining the fluid out of the body. The process does not require general anesthesia.

Local anesthesia is administered to numb the pain of the cut, which most people tend to feel once the numbness disappears. The process may need to be done more than once if the fluid accumulates in the pleural space.

There is a small risk of severe complications from chest drainage. These complications include infection, bleeding, or a collapsed lung. If the fluid drains too quickly, it is also possible for fluid to enter the lungs. These are uncommon complications, however.

Other treatments:

Other treatment routes may be necessary in some cases. Pleurodesis is closing the gap between the pleura of the lung and the thoracic cavity to prevent the accumulation of fluid between them.

More severe cases may also require surgery to direct fluid from the chest cavity into the abdomen. Doctors can also remove part of the pleural lining in extreme cases.


Pleural effusions can vary from non-serious to life-threatening. It depends to a large extent on the cause of the spill. The time it takes to heal depends on the severity of the effusion.

Pleural effusions may require a person to be hospitalized and monitored. Following a doctor’s directions, people can often find a treatment plan for the spill.