The Pleural Pathway is designed for patients who require investigation or treatment for problems affecting the space between the lung and the chest wall (the pleura), most commonly a build-up of fluid.

This pathway is led by Dr Mamoun Ibrahim, clinical lead for pleural diseases, and focuses on safe, timely, consultant-led care to:

  • identify the cause of the fluid
  • relieve symptoms such as breathlessness
  • plan further treatment where needed.

We also provide a specialist pleural service for patients referred by other teams within the hospital, including the lung cancer service, tuberculosis service, and other medical or surgical specialties. This ensures patients receive expert, consistent care regardless of where they are referred from.

Outpatient pathway (Same Day Emergency Care - SDEC)

If you are referred as an outpatient, you will usually be seen in our SDEC unit. This allows us to:

  • carry out investigations quickly
  • avoid unnecessary hospital admission
  • provide same-day assessment and treatment where possible.

What to expect during your visit

During your SDEC visit, you may have:

  • a clinical review. A detailed assessment of your symptoms, breathing, and medical history.
  • a chest ultrasound. This is a bedside scan that gives a clear view of the fluid around your lung. This helps us decide the safest and most appropriate procedure.
  • pleural aspiration. A small amount of fluid is removed using a fine needle under ultrasound guidance. The procedure is done using local anaesthetic and most patients feel pressure rather than pain. It usually takes around 20-30 minutes. The fluid is sent to the laboratory to help determine the cause.

Inpatient procedures

If you are admitted to hospital, we may carry out more advanced procedures. All pleural procedures are performed or directly supervised by a consultant respiratory physician to ensure safety and quality.

Treatments we provide

Pleural aspiration. This therapeutic drainage removes a larger amount of fluid to improve breathing and reduce chest discomfort.
Many patients feel relief shortly after the procedure. In some cases, this treatment can also help avoid hospital admission or support earlier discharge.

Chest drain insertion. A small, flexible tube is placed into the chest to drain fluid or air over time.

  • it is usually inserted under local anaesthetic
  • it is secured in place and monitored on the ward
  • it allows gradual, controlled drainage.

Are there any risks?

Pleural procedures are generally safe, especially when performed under ultrasound guidance. However, as with any procedure, there are small risks, including:

  • pain or discomfort
  • bleeding
  • infection
  • air leak 

Your doctor will explain these clearly and answer any questions before proceeding.

After the procedure

  • you might be given a chest X-ray if needed
  • you will be monitored for a short period
  • most patients can go home the same day (SDEC pathway).

You will be given advice on when to seek medical help and who to contact if you have concerns.

Next steps and results

Laboratory results usually take a few days. Your case will be reviewed by the consultant-led respiratory team, and you will be contacted with your results.

  • a follow-up appointment will be arranged if needed
  • further tests or treatment will be discussed

Who to contact

If you have any concerns after your procedure, please contact the Respiratory Team - 01895 279266.