There is enechoic area between the spleen and pleura the diaph. is separated from the lung. The USG is the investigation of choice for minimal pleural effusion and subpulmonic pleural effusion. The minimum fluid required to be seen on x-ray chest is approx. 200ml. The otherway to diagnose minimal pleural effusion is to take decubitus view. This view is done from backside in sitting position.
For tapping— Either it is done in radiodiagnosis dept or on bed side after getting the site marked under USG. Under all aseptic conditions, Prior to aspiration :- 1. local anesthesia should be given. 2. Consent of patient must. 3. Mark the site with maximum width.4. Give Depth from skin to mid of effusion.5. Aspiration to be done slowly and not to damage lung.
Pleural effusion:- The ultra sound is the best investigation for minimal pleural effusion and for sub pulmonic pleural effusion. The x-ray chest only shows effusion when the fluid quantity is more then 200ml.
The present image show an anechoic area between diaphragm and lung- pleural effusion.
To tap it should be done under ultrasound guidance.
Steps
- Mark the site.
- clean the site
- infiltrate local anaesthesia.
- aspirate
- straw color – tubercular, creamy colour- pyogenic, hemorrhagic- malignant.
