Showing papers on "Hydrothorax published in 1997"
TL;DR: It was found that all eight tests had similar diagnostic accuracies when evaluated by receiver operating characteristic (ROC) analysis except for BILI-R, which was less diagnostically accurate.
221 citations
TL;DR: This study shows that TIPS can be effective in the management of symptomatic, refractory hepatic hydrothorax and clinical and laboratory improvement may be seen and liver transplantation may become unnecessary.
184 citations
TL;DR: It is concluded that pleural fluid analysis has limited diagnostic efficacy in the patient with cirrhosis and data collected by other methods--clinical and radiologic--should assist in arriving at the correct diagnosis.
Abstract: Although fluid analysis usually is the first step toward identifying the cause of pleural effusion in patients with cirrhosis and ascites, there are no available data on the reliability of this approach, therefore, we retrospectively evaluated hematologic and biochemical parameters from pleural fluid analysis in 21 patients with hepatic hydrothorax (with proven peritoneal-pleural communication) and 6 patients with primary pleural disease (2 with tuberculosis, 3 with parapneumonic effusion, and 1 with empyema). The criteria developed by Light were diagnostic of pleural "exudate" in only one of six patients with primary pleural disease, concentrations of leukocytes, total protein (TP), albumin, and lactic dehydrogenase (LDH) in both fluids were measured and pleural fluid-to-ascites ratios of these measurements were calculated. Only ratio values for leukocytes and TP were higher in the group of patients with primary pleural disease compared with those with hepatic hydrothorax. Ratio values for leukocytes and TP overlapped between both groups during baseline conditions and during episodes of spontaneous bacterial peritonitis and pleuritis. We conclude that pleural fluid analysis has limited diagnostic efficacy in the patient with cirrhosis. Data collected by other methods--clinical and radiologic--should assist in arriving at the correct diagnosis.
42 citations
TL;DR: A 3-year-old girl who developed cerebrospinal fluid hydrothorax and respiratory distress is reported, caused by migration of the intra-abdominal catheter through the right vertebrocostal trigone of Bochdalek, the one most unlikely to be congenitally patent.
Abstract: Cerebrospinal fluid hydrothorax is a very rare complication following ventriculoperitoneal shunting. The authors report a case of a 3-year-old girl who developed cerebrospinal fluid hydrothorax (caused by migration of the intra-abdominal catheter through the right vertebrocostal trigone of Bochdalek, the one most unlikely to be congenitally patent) and respiratory distress. The patient was successfully treated with thoracocentesis and shunt revision.
31 citations
TL;DR: The subject of this study was 38 cases of non-immune hydrops fetalis and 11 cases of fetal hydrothorax and/ or ascites (FH/A), a syndrome characterized by the accumulation of pleural effusion and/or ascitic fluid, admitted to the obstetrics ward of Hokkaido University Hospital during the period between 1987 and 1994.
Abstract: The subject of this study was 38 cases of non-immune hydrops fetalis and 11 cases of fetal hydrothorax and/ or ascites (FH/A), a syndrome characterized by the accumulation of pleural effusion and/or ascitic fluid, without generalized skin edema, due to various etiologies, admitted to the obstetrics ward of Hokkaido University Hospital during the period between 1987 and 1994. Fetal treatment consisted of (1) intravascular transfusion or intra-abdominal transfusion for anemia, (2) frequent centesis or shunt insertion for pleural effusion and ascites, (3) reduction of cystic hygroma by puncturing and OK432 injection, and (4) intravascular or maternal injection with an anti-arrhythmic drugs to treat tachycardia. The outcome of NIHF and FH/A was assessed to be able to make a prognosis in NIHF and to compare the efficacy of fetal therapy in cases with (15 cases: 9 NIHF, 6 FH/A) and without (34 cases: 29 NIHF, 5 HF/A) intrauterine treatment. The average survival rates were 23.1% in NIHF and 54.5% in FH/A. None of fetuses with a chromosomal abnormality or cystic hygroma survived. The average GW at the time of detection of NIHF by ultrasonography was week 24.9 +/- 1.1 (mean +/- S.E., n = 38). The average GW at the time of detection of FH/A by ultrasonography was week 26.6 +/- 1.8 (n = 11). NIHF was detected significantly earlier in the IUFD and early neonatal death group (GW 22.4 +/- 1.4) than in the survivor group (GW 27.6 +/- 1.2) (p < 0.05). FH/A was also detected earlier in the IUFD/early neonatal death group than in the survivor group (GW 21.8 +/- 2.4 vs. 31.1 +/- 1.1, n = 11, p < 0.05). The survival rate in the intrauterine treatment group was higher than in the nontreatment group (treatment group: 10/15; non-treatment group: 5/34, p < 0.001). After the trial of intrauterine treatment in the 15 cases mentioned above, some efficacy was observed in 7 cases (reduction of cysts, effusion or edema, disappearance of arrhythmia).
28 citations
27 citations
Journal Article•
TL;DR: This unique presentation of pseudo-Meigs' syndrome should be included with malignancy in the differential diagnosis of a pelvic mass with ascites.
Abstract: BACKGROUND: Pseudo-Meigs' syndrome, or atypical Meigs' syndrome, occurs when a pelvic mass other than an ovarian fibroma is present with hydrothorax and ascites. Leiomyomas rarely cause this condition. CASE: An otherwise healthy 31-year-old woman presented to the emergency department in acute respiratory distress with massive ascites, pleural effusion and a pedunculated leiomyoma. After receiving mechanical ventilation, she underwent myomectomy and recovered fully within four weeks. CONCLUSION: This unique presentation of pseudo-Meigs' syndrome should be included with malignancy in the differential diagnosis of a pelvic mass with ascites.
16 citations
TL;DR: A case of long-term successful application of pleurovenous shunting for the management of pleural effusion in patients with intractable symptomatic hydrothorax after failure of traditional treatment by mechanical pleurodesis.
16 citations
TL;DR: In 40 cases there were no complications related to the procedure and one dog with severe pleural adhesions was euthanased because of lung perforation and pneumothorax secondary to misplacement of the catheter.
Abstract: A technique for virtually atraumatic placement of small size chest catheters for suction drainage of pleural effusions and pneumothorax in the dog and cat is described. Thirty-nine dogs and two cats were treated for pyothorax (10 cases), hydrothorax (eight), chylothorax (three), haemothorax (three), haemothorax/ pneumothorax (three) and pneumothorax (14). In all 41 cases, thin or viscous fluid and/or air were efficiently drained. The mean period of drainage was four days (range, 0.5 to 18 days). The average amount of fluid removed from each patient in 24 hours was 530 ml in pyothorax cases (range, 140 to 1100 ml) and 1300 ml in the other cases (range, 20 to 5000 ml). In 40 cases there were no complications related to the procedure. One dog with severe pleural adhesions was euthanased because of lung perforation and pneumothorax secondary to misplacement of the catheter.
13 citations
Journal Article•
TL;DR: A case of hepatic hydrothorax is presented as a reminder that a large, recurring pleural effusion may have an abdominal source, even in patients with minimal or no apparent ascites, as well as a simple radionuclide imaging procedure.
Abstract: A case of hepatic hydrothorax is presented as a reminder that a large, recurring pleural effusion may have an abdominal source, even in patients with minimal or no apparent ascites. One of the known mechanisms for hepatic hydrothorax is a peritoneopleural communication, as demonstrated in this case. A simple radionuclide imaging procedure, in which technetium 99m-sulfur colloid is injected into the peritoneal cavity prior to imaging of the chest and abdomen, can be used to document this finding. Treatment may include therapeutic thoracentesis, salt and water restriction, diuretics, tube thoracostomy with pleurodesis, surgical repair or placement of a portosystemic shunt.
9 citations
TL;DR: A patient with massive hydrothorax that appeared during CAPD was described and the pleurodesis using tetracycline was commenced and this allowed the successful continuance of CAPD.
Abstract: Massive hydrothorax is an Infrequent but well-recognized complication of continuous ambulatory peritoneal dialysis (CAPD), and is often regarded as a contraindication to its use. We describe here a patient with massive hydrothorax that appeared during CAPD. Peritoneoscintigraphy was performed to demonstrate the clinical suspicion of a pleuroperitoneal communication and the pleurodesis using tetracycline was commenced and this allowed the successful continuance of CAPD.
TL;DR: After extensive efforts failed to reveal the cause of effusion, intraperitoneal radioisotope study confirmed a peritoneopleural communication associated with unsuspected and asymptomatic hepatitis C-induced cirrhosis of the liver with portal hypertension.
Journal Article•
TL;DR: It is emphasised that the routine chest X-ray examination is necessary after pneumoperitoneum of long duration because blood gas data were improving, and the tracheal tube was extubated.
Abstract: We experienced a case of the hydrothorax occurring after a long gynecologic laparoscopical surgery. The patient was a 36-year-old woman, weighing 51 kg and 151 cm in height. She had received a gynecological laparoscopy with no complication 5 years before. She showed no abnormalities in the preoperative examinations. The operative course was uneventful. Upon completion of the surgery, we examined the chest X-ray, and found the hydrothorax in the right thoracic cavity. A 16 gauge Angiocath was inserted into the 4th intercostal space, and found 770 ml of fluid containing saline solution, which had been used for irrigating around the uterus. We presumed the saline, which was withdrawn from the right thoratic space, had originated from vertebrocostal trigone in the diaphragm. Because blood gas data were improving, the tracheal tube was extubated. We emphasise that the routine chest X-ray examination is necessary after pneumoperitoneum of long duration.
Journal Article•
TL;DR: It can be concluded that monitoring fetal well-being by means of cardiotocography and Doppler velocimetry may help in timing thoracentesis in cases of fetal hydrothorax.
Abstract: Fetal hydrothorax is associated with elevated perinatal mortality. Management of this condition is controversial given that in utero spontaneous resolution has been described. A case of fetal hydrothorax associated with an extralobar lung sequestration that showed pathologic cardiotocographic patterns and abnormal Doppler velocimetry indices in several fetal vascular beds in reported. All pathologic patterns improved after fetal thoracentesis. It can be concluded that monitoring fetal well-being by means of cardiotocography and Doppler velocimetry may help in timing thoracentesis in cases of fetal hydrothorax.
Journal Article•
TL;DR: A premature infant who developed right-sided hydrothorax due to fluid infusion through a malpositioned UVC is reported.
Abstract: Umbilical venous catheters (UVC) are still used occasionally for fluid infusion in newborn infants. Although many complications have been reported, hydrothorax rarely occurs. We report a premature infant who developed right-sided hydrothorax due to fluid infusion through a malpositioned UVC.
TL;DR: An unusual case of dynamic variation in the extent of fetal hydrothorax is presented with a variable course in pregnancy.
Abstract: Fetal pleural effusions have a variable course in pregnancy. An unusual case of dynamic variation in the extent of fetal hydrothorax is presented.