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Peritoneal - Fluid on the Abdomen
This is an accumulation of fluid produced by the mesothelioma tumour in the space between the two layers of the pleural membrane. The majority of people with pleural mesothelioma develop pleural effusions, particularly in the early stage of the disease. Large effusions, particularly if they develop rapidly, may cause severe shortness of breath.
The effusion is confirmed by chest x-ray and the immediate treatment is drainage (‘aspiration’, ‘pleural tap’ or ‘thoracocentesis’) in hospital with rapid relief of breathlessness. In some cases the drainage tube is left in place for a few days to ensure all the fluid is removed. Unfortunately pleural effusions often recur and can become increasingly difficult to drain because the fluid tends to form in pockets (ie becomes ‘loculated’) or becomes very sticky.
In order to prevent recurrent effusions the procedure of pleurodesis is performed. 
Pleurodesis is a method of making the two layers of the pleural membrane stick together which obliterates the space between them thus preventing the formation of further effusions. The procedure involves introducing an irritant material, usually sterile talc, via a tube (either a chest drain or thoracoscope) into the space between the pleural layers (any fluid has to be drained first). This is sometimes aided by video-camera viewing of the inside of the chest – a VATS (video-assisted thoracoscopy) procedure. Pleurodesis tends to be successful in most cases, particularly if performed early on in the disease.
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© Mesothelioma UK 2013