Pleural Effusion
Hydrops Fetalis
Paracentesis
Bronchopulmonary Sequestration
Subclavian Vein
Pleural Cavity
Meigs Syndrome
Pleurodesis
Hydrothorax: an unexpected complication after laparoscopic myomectomy. (1/67)
We report a case of hydrothorax as a complication of laparoscopic myomectomy in an otherwise healthy woman. The most likely cause of the patient's hydrothorax was irrigation fluid moving from the peritoneal cavity into the pleural space via defects in the diaphragm. Anaesthesists and surgeons should consider hydrothorax as a potential complication in any patient undergoing laparoscopy. (+info)Ex utero intrapartum treatment (EXIT) of severe fetal hydrothorax. (2/67)
Ex utero intrapartum treatment (EXIT) of a fetus with severe bilateral hydrothorax is described. EXIT allows therapeutic interventions on the neonate while maintaining fetoplacental circulation. Thus it may be useful for fetuses presenting with severe pleural effusion towards the end of gestation and in whom in utero drainage is technically not possible or available and drainage post partum would result in profound and prolonged hypoxia until sufficient drainage of pleural fluid allowed lung expansion. (+info)Physiology and pathophysiology of pleural fluid turnover. (3/67)
Tight control of the volume and composition of the pleural liquid is necessary to ensure an efficient mechanical coupling between lung and chest wall. Liquid enters the pleural space through the parietal pleura down a net filtering pressure gradient. Liquid removal is provided by an absorptive pressure gradient through the visceral pleura, by lymphatic drainage through the stomas of the parietal pleura, and by cellular mechanisms. Indeed, contrary to what was believed in the past, pleural mesothelial cells are metabolically active, and possess the cellular features for active transport of solutes, including vesicular transport of protein. Furthermore, the mesothelium was shown, on the basis of recent experimental evidence, both in vivo and in vitro, to be a less permeable barrier than previously believed, being provided with permeability characteristics similar to those of the microvascular endothelium. Direct assessment of the relative contribution of the different mechanisms of pleural fluid removal is difficult, due to the difficulty in measuring the relevant parameters in the appropriate areas, and to the fragility of the mesothelium. The role of the visceral pleura in pleural fluid removal under physiological conditions is supported by a number of findings and considerations. Further evidence indicates that direct lymphatic drainage through the stomas of the parietal pleura is crucial in removing particles and cells, and important in removing protein from the pleural space, but should not be the main effector of fluid removal. Its importance, however, increases markedly in the presence of increased intrapleural liquid loads. Removal of protein and liquid by transcytosis, although likely on the basis of morphological findings and suggested by recent indirect experimental evidence, still needs to be directly proven to occur in the pleura. When pleural liquid volume increases, an imbalance occurs in the forces involved in turnover, which favours fluid removal. In case of a primary abnormality of one ore more of the mechanisms of pleural liquid turnover, a pleural effusion ensues. The factors responsible for pleural effusion may be subdivided into three main categories: those changing transpleural pressure balance, those impairing lymphatic drainage, and those producing increases in mesothelial and capillary endothelial permeability. Except in the first case, pleural fluid protein concentration increases above normal: this feature underlies the classification of pleural effusions into transudative and exudative. (+info)Echocardiographic evaluation of fetal hydrothorax: the effusion ratio as a diagnostic tool. (4/67)
OBJECTIVE: Fetal hydrothorax may lead to hydrops and is associated with mortality as high as 50%. The objective of this study was to define the pathophysiology of fetal hydrothorax and its relation to hydrops. METHODS: Measurements from echocardiograms of 33 fetuses diagnosed with hydrothorax were made, and included diameters of the thorax, heart, inferior vena cava, right ventricle (RV), left ventricle (LV) and aortic and pulmonary valves. Doppler-derived velocities were measured in the aorta and pulmonary artery just above the aortic and pulmonary valves. The ratio of the area of the effusion to the area of the thorax (effusion ratio) was calculated. Variables were converted into Z-scores from regression equations based on normal data. Features of fetuses with and without hydrops were compared. RESULTS: Higher effusion ratios were noted in hydropic versus non-hydropic fetuses. Compared to a normal population, study subjects had smaller dimensions of LV, RV and aortic and pulmonary valves. They also had higher pulmonary artery peak velocities. The comparison between non-hydropic and hydropic fetuses revealed lower values for LV and pulmonary valve dimensions, and peak aortic velocity in hydropic fetuses. The severity of LV compression correlated significantly with effusion ratio. CONCLUSION: Fetal hydrothorax is accompanied by compression of the cardiac structures, resulting in altered cardiac hemodynamics. Echocardiographic assessment, including the measurement of effusion ratio, may be a useful tool in guiding fetal therapy. (+info)Congenital chylothorax: a case report. (5/67)
A case of unilateral congenital hydrothorax diagnosed at 21 weeks and treated with a pleuro-amniotic shunt at 23 weeks' gestation is presented. The rapid production of pleural fluid led to the development of polyhydramnios which was treated with a selective Cox inhibitor. Due to worsening of the hydrothorax, a third thoracocentesis was performed at 30 weeks' gestation prior to a Cesarean section. The neonate responded well to mechanical ventilation, a thoracic drainer that was inserted between days 5 and 14, fluid and protein replacement and gradual transition from parenteral to intestinal nutrition. Early diagnosis of chylothorax should be treated by thoraco-amniotic drainage to prevent fetal pulmonary hypoplasia and congestive cardiac failure. Polyhydramnios is a complication of this therapy and may require treatment with a Cox inhibitor. (+info)Video-assisted thoracoscopic talc pleurodesis is effective for maintenance of peritoneal dialysis in acute hydrothorax complicating peritoneal dialysis. (6/67)
BACKGROUND: Acute, massive, unilateral hydrothorax is an uncommon but well-recognized complication of peritoneal dialysis. Its clinical course and treatment outcome after a recently advocated technique of video-assisted thoracoscopic (VATS) talc pleurodesis remains unclear. METHODS AND RESULTS: Between July 1998 and March 2002, among 475 CAPD patients in two regional hospitals in Hong Kong, nine patients (three men, six women, mean age 53+/-12 years) developed acute hydrothorax due to pleuroperitoneal communication (R=8, L=1) within 5.8+/-4.2 months (median, 5.2 m; range, 2 days to 11.6 months) of commencing peritoneal dialysis. Analysis of simultaneously obtained peritoneal and pleural fluid in all subjects only showed concordance in protein content (consistently<4 g/l), while fluid glucose and lactate dehydrogenase levels were not comparable. The methylene blue test was negative (n=4). Radionuclide scan (n=6) and contrast CT peritoneography (CTP, n=3) detected pleuroperitoneal communication in half and one-third of the patients, respectively. All patients underwent pleurodesis achieved by talc insufflation into the pleural cavity under VATS guidance. All patients were successfully returned to peritoneal dialysis. After a mean follow-up of 18.8+/-12.5 months, hydrothorax recurred in one patient (at 7 months after pleurodesis), who was successfully treated by repeating the procedure. CONCLUSIONS: Hydrothorax complicating CAPD is more commonly right-sided, and tends to occur within the first year of starting peritoneal dialysis. Isotope scan and CTP are insensitive in diagnosing pleuroperitoneal communication. A low pleural fluid protein content is the most consistent biochemical finding. VATS talc pleurodesis is a safe and reliable treatment of choice that allows sustained continuation of CAPD with low recurrence rate. (+info)Isolated non-chylous pleural effusion in two neonates. (7/67)
Isolated pleural effusion, so called primary pleural effusion denotes a pleural effusion without documented etiology such as a cardiac, inflammatory, iatrogenic problem or fetal hydrops. Chromosomal anomaly such as Down syndrome may be associated with isolated pleural effusion. The content of the isolated pleural effusion is mostly chylous, and isolated non-chylous pleural effusion in neonate is rare. We experienced 2 cases of isolated non-chylous pleural effusion. They had neither cardiac problem nor other sign of hydrops fetalis. Imaging diagnosis was done by plain chest radiography and subsequent ultrasonogram. One of them was diagnosed to Down syndrome by karyotyping. They were fared well after diagnostic and therapeutic thoracentesis. We describe 2 cases of non-chylous pleural effusion and review a few English-language case reports of this entity. (+info)ATYPICAL MANIFESTATIONS OF HYPERTHYROIDISM. (8/67)
Patients with hyperthyroidism usually present with symptoms of hypermetabolism with or without goitre and/or eye signs. Occasionally, however, the chief complaints are not immediately suggestive of hyperthyroidism. Patients with hyperthyroidism are described who presented with such atypical manifestations as periodic muscular paralysis, myasthenia, myopathy, encephalopathy, psychosis, angina pectoris, atrial fibrillation, heart failure without underlying heart disease, skeletal demineralization, pretibial myxedema, unilateral eye signs, and pitting edema of the ankles. (+info)Hydrothorax is a medical term that refers to the abnormal accumulation of serous fluid in the pleural space, which is the potential space between the lungs and the chest wall. This condition often results from various underlying pathological processes such as liver cirrhosis, heart failure, or kidney disease, where there is an imbalance in the body's fluid regulation leading to the accumulation of fluid in the pleural cavity. The presence of hydrothorax can cause respiratory distress and other symptoms related to lung function impairment.
Pleural effusion is a medical condition characterized by the abnormal accumulation of fluid in the pleural space, which is the thin, fluid-filled space that surrounds the lungs and lines the inside of the chest wall. This space typically contains a small amount of fluid to allow for smooth movement of the lungs during breathing. However, when an excessive amount of fluid accumulates, it can cause symptoms such as shortness of breath, coughing, and chest pain.
Pleural effusions can be caused by various underlying medical conditions, including pneumonia, heart failure, cancer, pulmonary embolism, and autoimmune disorders. The fluid that accumulates in the pleural space can be transudative or exudative, depending on the cause of the effusion. Transudative effusions are caused by increased pressure in the blood vessels or decreased protein levels in the blood, while exudative effusions are caused by inflammation, infection, or cancer.
Diagnosis of pleural effusion typically involves a physical examination, chest X-ray, and analysis of the fluid in the pleural space. Treatment depends on the underlying cause of the effusion and may include medications, drainage of the fluid, or surgery.
Hydrops Fetalis is a serious condition characterized by the accumulation of excessive fluid in two or more fetal compartments, including the abdomen (ascites), around the heart (pericardial effusion), and/or within the lungs (pleural effusion). This accumulation can also affect the skin, causing it to become edematous. Hydrops Fetalis is often associated with various underlying causes, such as chromosomal abnormalities, congenital infections, genetic disorders, and structural defects that impair the fetus's ability to maintain fluid balance. In some cases, the cause may remain unknown. The prognosis for Hydrops Fetalis is generally poor, with a high mortality rate, although early detection and appropriate management can improve outcomes in certain situations.
Paracentesis is a medical procedure in which a thin needle or catheter is inserted through the abdominal wall to remove excess fluid from the peritoneal cavity. This procedure is also known as abdominal tap or paracentesis aspiration. The fluid removed, called ascites, can be analyzed for infection, malignant cells, or other signs of disease. Paracentesis may be performed to relieve symptoms caused by the buildup of excess fluid in the abdomen, such as pain, difficulty breathing, or loss of appetite. It is commonly used to diagnose and manage conditions such as liver cirrhosis, cancer, heart failure, and kidney failure.
Bronchopulmonary sequestration is a rare birth defect of the lungs, in which a mass of abnormal lung tissue develops that doesn't function and isn't connected to the tracheobronchial tree (the airways that lead to the lungs). This means that the abnormal tissue receives its blood supply from an anomalous systemic artery instead of the normal pulmonary circulation. The mass may be located within the lung (intralobar sequestration) or outside the lung (extralobar sequestration), and it can occur on either side of the chest.
Intralobar sequestrations are more common than extralobar sequestrations, accounting for about 75% of cases. They are usually found in adults and are located within a normal lung tissue. Extralobar sequestrations, on the other hand, are typically detected earlier in life (often as an incidental finding during prenatal ultrasound) and are surrounded by their own pleural lining, which can make them appear separate from the normal lung tissue.
Symptoms of bronchopulmonary sequestration may include recurrent respiratory infections, coughing up blood (hemoptysis), shortness of breath, or chest pain. Treatment usually involves surgical removal of the abnormal tissue to prevent complications such as infection, bleeding, or the development of malignancy.
The subclavian vein is a large venous structure that carries deoxygenated blood from the upper limb and part of the thorax back to the heart. It forms when the axillary vein passes through the narrow space between the first rib and the clavicle (collarbone), becoming the subclavian vein.
On the left side, the subclavian vein joins with the internal jugular vein to form the brachiocephalic vein, while on the right side, the subclavian vein directly merges with the internal jugular vein to create the brachiocephalic vein. These brachiocephalic veins then unite to form the superior vena cava, which drains blood into the right atrium of the heart.
The subclavian vein is an essential structure for venous access in various medical procedures and interventions, such as placing central venous catheters or performing blood tests.
The pleural cavity is the potential space between the visceral and parietal pleura, which are the two membranes that surround the lungs. The visceral pleura covers the outside of the lungs, while the parietal pleura lines the inside of the chest wall. Under normal conditions, these two layers are in contact with each other, and the space between them is virtually nonexistent. However, when air, fluid or inflammation accumulates within this space, it results in the formation of a pleural effusion, which can cause discomfort and difficulty breathing.
Ascites is an abnormal accumulation of fluid in the peritoneal cavity, which is the space between the lining of the abdominal wall and the organs within it. This buildup of fluid can cause the belly to swell and become distended. Ascites can be caused by various medical conditions, including liver cirrhosis, cancer, heart failure, and kidney disease. The accumulation of fluid in the peritoneal cavity can lead to complications such as infection, reduced mobility, and difficulty breathing. Treatment for ascites depends on the underlying cause and may include diuretics, paracentesis (a procedure to remove excess fluid from the abdomen), or treatment of the underlying medical condition.
Meigs syndrome is a rare medical condition characterized by the combination of ovarian tumor (most commonly fibroma or thecoma), ascites (abnormal accumulation of fluid in the abdominal cavity), and pleural effusion (fluid accumulation around the lungs). The hallmark feature of this syndrome is that all these symptoms resolve after the removal of the ovarian tumor.
It's important to note that not all women with ovarian tumors will develop Meigs syndrome, and its exact cause remains unclear. It primarily affects middle-aged women and is typically diagnosed through imaging tests (such as ultrasound or CT scan) and the exclusion of other possible causes of ascites and pleural effusion.
After surgical removal of the ovarian tumor, the ascites and pleural effusion usually resolve on their own within a few months. Meigs syndrome is not considered a malignant condition, but regular follow-ups are necessary to monitor for any potential recurrence of the ovarian tumor or development of other health issues.
Drainage, in medical terms, refers to the removal of excess fluid or accumulated collections of fluids from various body parts or spaces. This is typically accomplished through the use of medical devices such as catheters, tubes, or drains. The purpose of drainage can be to prevent the buildup of fluids that may cause discomfort, infection, or other complications, or to treat existing collections of fluid such as abscesses, hematomas, or pleural effusions. Drainage may also be used as a diagnostic tool to analyze the type and composition of the fluid being removed.
Pleurodesis is a medical procedure that involves the intentional inflammation and subsequent fusion of the pleural surfaces, which are the thin layers of tissue that separate the lungs from the chest wall. This procedure is typically performed to prevent the recurrence of pneumothorax (a collapsed lung) or pleural effusions (abnormal fluid accumulation in the pleural space).
During the pleurodesis procedure, an irritant such as talc, doxycycline, or silver nitrate is introduced into the pleural space. This causes an inflammatory response, leading to the formation of adhesions between the visceral and parietal pleura. These adhesions obliterate the potential space between the pleural layers, preventing the accumulation of air or fluid within that space.
There are two primary approaches to performing pleurodesis: thoracoscopic (using a video-assisted thoracoscopic surgery or VATS) and chemical (instilling a sclerosing agent through a chest tube). Both methods aim to achieve the same goal of creating adhesions between the pleural layers.
It is essential to note that, while pleurodesis can be an effective treatment for preventing recurrent pneumothorax or pleural effusions, it is not without risks and potential complications. These may include pain, fever, infection, empyema (pus in the pleural space), or acute respiratory distress syndrome (ARDS). Patients should discuss these risks with their healthcare provider before undergoing the procedure.
Hydrothorax
Hepatic hydrothorax
Leadhills
Francis E. Anstie
Meigs's syndrome
Chest tube
Pleural effusion
Amalie Raiffeisen
Laurentius Blumentrost
Proteinuria
Persin
Intraperitoneal injection
Ovarian hyperstimulation syndrome
Johann Georg Heine
Dennis Embleton
Water gas
Traumatic aortic rupture
Microbial toxin
Aspergillus ochraceus
Trocar
Coin test
Ovarian cancer
Ken Hung
Hydrops fetalis
Hemothorax
Mycotoxins in animal feed
Zeynel Mungan
Francesco La Cava
Percutaneous nephrolithotomy
Charles Darwin (medical student)
Hydrothorax - Wikipedia
Neonatal management and outcome after thoracoamniotic shunt placement for fetal hydrothorax | ADC Fetal & Neonatal Edition
AKUTER HYDROTHORAX UNTER PERITONEALDIALYSE
Hydrothorax | Profiles RNS
Towards an easier pleurodesis: Ultrasound-guided iodopovidone sclerotherapy in cirrhotic patients with hepatic hydrothorax
Massive Unilateral Pleural Effusion - Hepatic Hydrothorax - Manual of Medicine
Recurrent hydrothorax following repeated pleurodesis using autologous blood [4] | NTU Scholars
Massive hydrothorax following subclavian vein catheterization | International Archives of Medicine | Full Text
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Hepatic16
- More rarely, hydrothorax can develop in 10% of patients with ascites which is called hepatic hydrothorax. (wikipedia.org)
- Other measures such as a TIPS procedure are more effective as they treat the cause of the hydrothorax, but have complications such as worsened hepatic encephalopathy. (wikipedia.org)
- Pleural effusion Pneumothorax https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/hydrothorax Garbuzenko D.V., Arefyev N.O. Hepatic hydrothorax: An update and review of the literature. (wikipedia.org)
- Background and Aim: Hepatic hydrothorax is one of the complications encountered in end stage liver disease. (scirp.org)
- The aim of this study is to evaluate the effect of pleurodesis using ultrasound-guided iodopovidone sclerotherapy in hepatic hydrothorax. (scirp.org)
- Patients and Methods: This prospective study included 56 patients with clinical, laboratory and radiological evidence of liver cirrhosis and symptomatic right sided hepatic hydrothorax. (scirp.org)
- Conclusion: Ultrasound-guided iodopovidone sclerotherapy is an effective approach for a successful pleurodesis in hepatic hydrothorax. (scirp.org)
- Hepatic hydrothorax is a complication of end stage liver disease [1], ranging from 4% to 6%, and up to 10% with advanced disease [2]. (scirp.org)
- Occasionally, a hepatic hydrothorax may be present in the absence of ascites [3]. (scirp.org)
- Causes of hepatic hydrothorax include leakage from the thoracic duct, leakage through lymphatic channels in the diaphragm and leakage through diaphragmatic defects [4]. (scirp.org)
- Traditional treatment of hepatic hydrothorax in a patient who failed medical management of ascites remains problematic and controversial and no guideline for an ideal method is available at the present [8]. (scirp.org)
- Background/Aims: The management of hepatic hydrothorax (HH) remains a challenging clinical scenario with suboptimal options. (ewha.ac.kr)
- International survey among hepatologists and pulmonologists on the hepatic hydrothorax: plea for recommendations. (bvsalud.org)
- The aims of this article are which follows To gather the practices of hepatogastroenterologists or pulmonologists practitioners regarding the diagnosis and management of the hepatic hydrothorax . (bvsalud.org)
- Practitioners from 13 French- speaking countries were invited to answer an online questionnaire on the hepatic hydrothorax diagnosis and its management. (bvsalud.org)
- PURPOSE: Hepatic hydrothorax is a complication of decompensated liver cirrhosis that is difficult and complex to manage. (koreamed.org)
Pleural effusion1
- Hydrothorax is a type of pleural effusion in which transudate accumulates in the pleural cavity. (wikipedia.org)
Ascites2
- Examples include dropsy of the belly (ascites), the brain (hydrocephalus), the chest (hydrothorax), or the skin (anasarca) (Hooper, Lexicon Medicum , 1860). (floridamemory.com)
- Gross lesions in stillborn or weak, infected piglets include hydrocephalus, subcutaneous edema, ascites, hydrothorax, hemorrhages on serous membranes, congestion of lymph nodes and necrotic foci in the liver and spleen. (iastate.edu)
Fetal3
- Aim To evaluate the short-term neonatal outcome after fetal thoracoamniotic shunt placement for isolated hydrothorax. (bmj.com)
- Methods Retrospective evaluation of infants with isolated hydrothorax treated with thoracoamniotic shunt placement at our fetal therapy centre between 2001 and 2016. (bmj.com)
- Five percent (11) underwent treatment in utero for fetal hydrothorax, obstructive uropathy, twin-twin transfusion syndrome, or lymphangioma. (nih.gov)
Pulmonary1
- Necropsy and histologic lesions include pulmonary edema, hydrothorax, and pale myocardium. (usda.gov)
Liver1
- however, often the source of the hydrothorax is end stage liver disease and correctable only by transplant. (wikipedia.org)
Rarely1
- If simple fluid, then the term hydrothorax may be employed, although this is rarely used (other than in combination terms e.g. hydropneumothorax ). (radiopaedia.org)
Fluid2
- Hydrothorax is is a condition characterized by the accumulation of fluid in and around the lungs which can cause deep, rapid breathing, coughing, and panting. (newenglandanimalhosp.com)
- Hydrothorax is caused by the buildup of fluid in and around the lungs, which can lead to fast, heavy breathing, coughing, and panting. (felineliving.net)
Treatment1
- Treatment of hydrothorax is difficult for several reasons. (wikipedia.org)
Include1
- Symptoms of hydrothorax can include deep, rapid breathing, panting and coughing. (northeast-vet.com)
Website1
- This graph shows the total number of publications written about "Hydrothorax" by people in this website by year, and whether "Hydrothorax" was a major or minor topic of these publications. (jefferson.edu)
Fetal Hydrothorax1
- We have more than 20 years of experience in the treatment of fetal hydrothorax, a rare complication for which an experienced team is crucial. (sjdhospitalbarcelona.org)
Complication1
- Introduction Albeit uncommon, hydrothorax is an important complication of peritoneal dialysis (PD). (fujita-hu.ac.jp)
Thoracentesis1
- Following hydrothorax diagnosis by thoracentesis and detection of penetrated sites on the diaphragm using CT peritoneography, VATS was performed at a median time of 31 days (interquartile range [IQR], 20-96 days). (fujita-hu.ac.jp)
Thoracic1
- Due to paucity of evidence for optimal treatment, this study aimed to evaluate the effectiveness and safety of computed tomographic (CT) peritoneography and surgical intervention involving video-assisted thoracic surgery (VATS) for hydrothorax in a retrospective cohort of patients who underwent PD in Japan. (fujita-hu.ac.jp)
Patients1
- Methods Of the 982 patients who underwent PD from six centers in Japan between 2007 and 2019, 25 (2.5%) with diagnosed hydrothorax were enrolled in this study. (fujita-hu.ac.jp)
Cases2
- This approach may be useful in hydrothorax cases to avoid early drop out of PD and continue PD in the long term. (fujita-hu.ac.jp)
- The Fluoric acid was prescribed in this case according to Dr. Jeaness statement: 'In two cases of incurable hydrothorax Fluoric acid 3rd gave much relief. (homeoint.org)
Study1
- Conclusions This study demonstrated the effectiveness and safety of CT peritoneography and VATS for hydrothorax. (fujita-hu.ac.jp)