Abstract
Introduction: Pleural effusion is a clinical condition which caused by a variety of illnesses such as TB, cancer, parapneumonia, congestive heart failure, pulmonary embolism, and many more and most often it seen in patients with lung cancer.
Objective: The main objective of this study is to determine the diagnostic accuracy and problems associated with flexible pleuroscopy.
Materials and Method: This prospective study was conducted at tertiary hospital in Bangladesh. The duration of this study was one year (January 2020 to December 2020). Sample size: Total 60 patients with exudative pleural effusion was selected as sample diagnosed by chest x-ray, CT scan of chest and pleural fluid study (Protein, sugar, LDH) in whom diagnosis couldn’t be confirmed were consider for this study. Flexible pleuroscopy was performed aseptically under local anaesthetic in the 5th or 6th intercostal gaps in the mid-axillary line, and many (5-6) parietal pleura samples were collected in questionable locations.
Results: the patients were on average 56.7 years old, with 58.83 percent male and 41.67 percent female. Nearly 46.67 percent of individuals acquired flexible pleural effusions and 48.33 percent developed left pleural effusions. Three individuals had bilateral illness. Average value of pleural fluid for sugar is 6.6 mmol/L, protein is 4.2 g/dl and ADA is 46 U/L. In all, 95.7% of patients had a conclusive diagnosis. Only 8.7% of patients tested positive for malignant cells in a pleural fluid investigation, despite the fact that 60.8% of those tested had primary and secondary malignancies. Only 26.1% of patients were found to have TB, despite the fact that no tubercular organism could be found in either cytology or culture on any of them. Among the patients who underwent testing, 4.3% had empyema thoracis identified, and the same number of patients had normal pleura. Only two individuals (4.3 percent) had data that might be considered definitive.
Conclusion: Flexible pleuroscopy is a very important method for diagnosing previously undiscovered exudative pleural effusions when thoracentesis failed to provide an appropriate diagnosis.
Keywords: Pleural effusion, Flexible pleuroscopy, TB.
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Corresponding Author
Dr Mohammad Towfique Hasan
Assistant Professor, Respiratory Medicine, Sir Salimullah Medical College, Dhaka, Bangladesh
DOI: https://dx.doi.org/10.18535/jmscr/v10i5.03
