The Pleural service at Addenbrooke’s offers a personalised rapid referral diagnostic and treatment package for patients with pleural diseases such as pleural effusions, pneumothorax or other pleural abnormalities, for example, pleural thickening.

Pleural service
Box: 40 
Cambridge University Hospitals NHS Foundation Trust
Hills Road

Clinic 2a appointments: 01223 216645

Interventional Pulmonology & Pleural Team

Consultant Chest Physicians:
Dr Jurgen Herre (Lead)
Professor Stefan Marciniak
Dr Martin Knolle

Honorary Chest Physician:
Dr Thomas Pulimood

Senior Clinical Fellow:
Dr Keshav Sharma

Specialist Nurses:
Elaine Reid (Lead)
Hannah Collins

What is a pleural effusion?

A pleural effusion is a collection of fluid next to the lung for which there are various causes. The effusion may cause breathlessness and coughing. The fluid can be drained if necessary by either therapeutic thoracocentesis (see information sheets below) or chest drain insertion (see information sheets below). Treatment is mainly aimed at identifying and treating the underlying cause and we aim to offer a rapid service for patients with pleural effusions and help to direct management once the cause is established.

What is a pneumothorax?

A pneumothorax is air that is trapped next to a lung. Most cases occur 'out of the blue' in healthy young men. Some develop as a complication from a chest injury or a lung disease. The common symptom is a sudden sharp chest pain followed by pains on breathing in, often accompanied by breathlessness. In many cases, the pneumothorax clears without needing treatment but the trapped air of a large pneumothorax may need to be removed with the use of a chest drain if it causes breathing difficulty. An operation is needed in some cases.

What is pleural thickening?

Pleural thickening is thickening and hardening of the pleura which is the two-layered protective membrane covering the lung and surrounding the chest cavity. Pleural thickening is often linked to exposure to asbestos but it can develop from other sources such as inflammation and infection, injury to ribs, certain medications, after radiotherapy or associated with tumours. CT guided needle biopsy (see information sheets below) or biopsy at Medical Thoracoscopy (see information sheets below), if fluid is also present, is used to obtain tissue samples in order identify the cause of the thickening in order to direct treatment.

The pleural service offers Medical Thoracoscopy (see information sheets below) which is a procedure used for investigation and treatment of pleural and peripheral lung disease, carried out under local anaesthetic and light sedation and performed in the endoscopy department (see patient information leaflet below). It is a rapid, safe and efficient procedure for both diagnosis of pleural diseases and therapeutic pleurodesis.

The Pleural service also offer insertion of Indwelling Pleural Catheters (IPC)(see information sheets below) which are used for intermittent, long-term drainage and management of recurrent pleural effusions that do not respond to medical management of underlying disease.

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