What is the incidence of pleural effusions in acute pulmonary emboli?

Abstract

Introduction: Pleural effusions commonly occur in conjunction with acute pulmonary emboli (PE). There are no guidelines on the investigation and management of these effusions. We aimed to review local management.

Method: We reviewed all CTPAs in one trust in the UK in 2019. Electronic notes, imaging and discharge letters of patients with PE were reviewed.

Results: 1630 CTPAs were requested to investigate for PE. 316 (19.4%) were positive for PE. Of these, 86 (27.2%) were identified as having associated pleural effusions. Five (5.8%) patients had a contemporaneous pleural aspiration. All pleural effusions were exudative. Four were consistent with known malignant diagnoses. The other patient had concurrent pneumonia and pancreatitis.

Conclusions: This project is the largest single centre review. Although pleural effusions commonly occur with PE, pleural aspiration is rarely performed. Management is not significantly altered by the presence of an effusion.