Septated pleural effusion and the thin line between medical and surgical management

Septated or loculated pleural effusion can develop due to multiple pleuro- pulmonary etiologies. With increased use of bed side ultrasound early identification of septated effusion is increasing. Septated pleural fluid collections may be treated by thoracentesis, closed thoracostomy tube drainage, pleuroscopy or Video assisted thoracoscopic drainage, or surgical thoracotomy and decortication. If identified early a combination of drainage with fibrinolysis can be used to avoid surgical referrals.