K. E. Okonta1, .. O. Ocheli1 1University Of Port Harcourt Teaching Hospital,Cardiothoracic Unit, /Department Of Surgery,Port Harcourt, RIVERS, Nigeria
Introduction: To determine the aetiology and incidence and, comparing the mortality of malignant with non-malignant massive pleural effusion (MPE] in our setting
Methods: Prospective study of all the patients diagnosed of massive pleural effusion for one year in two tertiary federal Hospitals in southern part of the country, Nigeria. Forty-eight of 101 consecutive patients with MPE and required Chest Tube Drainage and chemical pleurodesis for malignant MPE. The patients were followed-up two weekly at clinic and phone calls
Results:Forty-eight patients(47.5%) had MPE with a mean age of 43 years + 14.04; 35were females and 13 were males with a ratio of 2.7:1.The cardinal symptoms were dyspnoea in 97.7%, cough in 79.1%,chest pain in 48.8% and weight loss in 39.5%. Eighteen patients(37.5%) had malignancy(11 from metastatic breast cancer and 7 in others).Thirty patients(62.5%) were diagnosed of non-malignant conditions-21(44.9%) from pulmonary tuberculosis. Haemorrhagic effusions were from Malignancy in 12(30.8%), pulmonary tuberculosis in 6(15.4%) and trauma in 3(7.7%); straw-coloured effusion were from malignancy in 9(23.1%), pulmonary tuberculosis in 8(20.1%).Eight of 14 patients diagnosed of malignant MPE died within 6 months. Compared with non malignant MPE, patients with malignant MPE had higher mortality (8/14 versus 0/23 with a p value of 0.000).
Conclusion:Pulmonary tuberculosis and Malignancy are the major contributors to the high incidence of MPE.The presentation of an adult patient with non traumatic haemorrhagic or straw-coloured MPE in this sub-region narrows the diagnosis to pulmonary tuberculosis and malignancy with malignant MPE being marker for short survival rate of 6 months