So, the last subject is pleural thickening.
Now this is what happens when you’ve had problems with
the pleura and the main problems that cause pleural
thickening long-term is previous pleural infection
including tuberculosis and bacterial infections,
previous blood in the pleural space such as
a hemothorax after trauma. And what happens
in these situations that the fluid that is
present during the acute event resolves, but
the pleura has been scarred by the process.
Therefore, you're left with a range of thickening
around the pleura, which makes the lung much
less able to expand and causes restrictive
defects in the lung function. So for example,
this is the chest X-ray of
a young man who presented with pneumonia and
empyema. Infact its the X-ray of the first
patient I showed was a pleural infection earlier.
And you can see that although we treated the
empyema with pleural drainage. He’s been left
with a considerable amount of pleural thickening
which is visible both on the side of the chest
with that characteristic squared off shape
of pleural thickening. And also, the back
of the lung there seems doing as well which
represents pleural thickening around the
back of the lung.
This doesn’t require treatment. It requires
prevention by drainage in the first place,
because once you’ve developed pleural thickening,
the only treatment that can be used is surgery.
And that is quite an invasive and difficult
task to remove all these pleural thickening
safely. The consequences of pleural thickening
well, not much apart from the fact that
the patient has lost their lung function.
They have more restrictive lung function,
and as a consequence, they’ll be able to
do less exercise and they will prior to the
problem that caused it in the first place.