Showing papers on "Hydrothorax published in 2002"
TL;DR: TIPS is a relatively safe and effective method of controlling HHyd and the majority of patients experienced improvement or resolution of clinical symptoms with a variable reduction in the quantity of pleural fluid.
102 citations
TL;DR: The correlation between these inflammatory cytokines and the clinical course of Meigs' syndrome suggests their involvement in the formation of ascites and hydrothorax in this disorder.
58 citations
58 citations
TL;DR: Symptomatic hepatic hydrothorax can be controlled with a single VATS with pleurodesis in as many as 53% of patients and with two procedures in 73% with no procedure-related mortality.
57 citations
TL;DR: This is the second reported case in the English language literature of pseudo-Meigs' syndrome with an elevated CA 125 level resulting from struma ovarii, a specialized ovarian teratoma composed predominantly of mature thyroid tissue.
52 citations
TL;DR: Changing the VP shunt for a ventriculo-atrial shunt resulted in immediate (within 1 day) complete disappearance of the pleural effusion and of the patient's chest symptoms.
Abstract: Cerebrospinal fluid hydrothorax is reported as a rare complication of ventriculoperitoneal (VP) shunt. A 16-month-old boy known to have congenital hydrocephalus and a Dandy-Walker cyst presented with serious respiratory distress. Examination revealed right pleural effusion and congested throat. Thoracocentesis with drainage of the pleural cavity for 10 days failed to free the patient from pleural effusion. Following an intraperitoneal injection of Omnipaque a chest X-ray was done, and samples of pleural fluid taken before and after the injection were compared on X-ray, revealing the presence of contrast in the postinjection pleural effusion. Changing the VP shunt for a ventriculo-atrial shunt resulted in immediate (within 1 day) complete disappearance of the pleural effusion and of the patient's chest symptoms. Probable causes of this rare complication are discussed, and attention is drawn to the possibility of its appearance and early recognition. Intraperitoneal injection of contrast material followed by X-ray examination of fluid in the chest is a simple, safe, and reliable method of diagnosis when it is suspected.
43 citations
TL;DR: With thoracoscopic pleurodesis, patients resumed continuous ambulatory peritoneal dialysis without recurrence of hydrothorax on long-term follow-up.
29 citations
TL;DR: The first case of infected mediastinitis associated with central venous catheter-related bloodstream infection and catheter perforation of superior vena cava is described.
Abstract: We describe the first case of infected mediastinitis associated with central venous catheter insertion. The rare occurrence of this complication may be explained by the fact that it results from central venous catheter-related bloodstream infection and catheter perforation of superior vena cava. The symptoms of this complication (chest pain, dyspnoea) are not specific. Diagnosis should be confirmed by chest x-ray and computerized tomography which show hydromediastinum and pleural effusion. Removal and subsequent culture of the catheter tip will confirm infection. Appropriate antibiotic therapy, guided by sensitivities of the cultured organisms, should be commenced. Any pleural effusion should be drained by thoracocentesis, and the pleural fluid cultured. In case of fever, bacteraemia or shock, a thoracotomy to drain mediastinal and pleural effusions may be considered.
28 citations
TL;DR: Ex utero intrapartum treatment (EXIT) of a fetus with severe bilateral hydrothorax is described, which allows therapeutic interventions on the neonate while maintaining fetoplacental circulation.
Abstract: 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.
26 citations
TL;DR: A further case of a young woman with pseudo-Meigs syndrome combined with bladder attachment and elevated CA-125 is presented, the 24th in literature, where the bladder was tightly attached, and the vascularisation seemed to come from the uterus and the bladder.
Abstract: Introduction: Pseudo-Meigs syndrome is a rare syndrome with pelvic tumors (not ovarian fibromas), which is combined with ascites and hydrothorax. Up to now 23 cases of pseudo-Meig
25 citations
Journal Article•
TL;DR: It is concluded that prevention of RPO is the desired goal in the management of pleural effusion or Pneumothorax and its incidence and severity reduced by methods of gradual evacuation of PThx or pleural fluid drainage.
Abstract: One hundred and one (6%) of 1,678 patient studied had bilateral reexpansion pulmonary oedema(RPO). On the whole, one thousand, seven hundred and seventy nine (1,779) pleural spaces were studied, fifteen pleural spaces (0.8%), with mean age of 23 +/- 4.5 years had RPO. Among these 15 patients with RPO, the mean period of lung collapse before pneumothorax (PThx) was evacuated was 31.8 +/- 21.8 days and for hydrothorax (HThx) was 31.3 +/- 30.1 days; for 15 patients without RPO (controls), matched for age and sex, the mean period of lung collapse before CTTD was 7.5 +/- 4.1 days and 5.4 +/- 1.3 days respectively for PThx and HThx. The differences in the period of lung collapse among patients with RPO and those without, for each pleural disease was statistically significant (P < 0.03). Volume of pleural fluid drained before RPO was noticed was 2196 +/- 1103 mls, for the 15 matched patients without RPO (controls), it was 1060 +/- 115 mls (p < 0.05). Volume of pleural fluid drained among the patients with SR (Severe response), MR (mild to moderate response) and RD (radiological diagnosis) did not correlate with severity of response. We conclude that prevention of RPO is the desired goal in the management of pleural effusion or Pneumothorax. RPO is commonest among young patients who have had lung collapse for 7 or more days. In these circumstances RPO is prevented, its incidence and severity reduced by methods of gradual evacuation of PThx or pleural fluid drainage.
TL;DR: The patient was a 52-year-old woman who presented to the hospital with progressive dyspnea who consumed a variety of vitamins, including vitamin A, and a transjugular liver biopsy revealed histopathologic changes consistent with vitamin A toxicity.
Abstract: We report the first case of an adult presenting with respiratory symptoms caused by hepatic hydrothorax secondary to vitamin A intoxication. The patient was a 52-year-old woman who presented to the hospital with progressive dyspnea. Evaluation demonstrated mild elevation of her liver function tests, ascites, and a right pleural effusion. The patient consumed a variety of vitamins, including vitamin A. Her estimated vitamin A intake was at least 162,300,000 international units (IU) during 18 years. She dramatically escalated her dose the year before admission for a total acute dose of 98,550,000 IU, with a daily intake of 270,000 IU. The recommended daily allowance is 4,000 IU. A transjugular liver biopsy revealed histopathologic changes consistent with vitamin A toxicity: hypertrophy and hyperplasia of hepatic stellate cells, focal pericellular fibrosis, mild perivenular fibrosis, and minimal, predominantly microvesicular steatosis. Despite the absence of cirrhosis, pressure readings demonstrated portal hypertension. During her hospitalization, the patient's symptoms and biochemical profile improved. As the large and generally unregulated United States dietary supplement industry continues to grow, it is increasingly likely that individuals will present with the signs and symptoms of vitamin excess rather than vitamin deficiency. Physicians need to remain alert to the varied presentations and toxic manifestations of excessive vitamin use.
TL;DR: A 67-year-old woman with neurofibromatosis type 1 presented with progressive dyspnea and progression of a giant meningocele associated with hydrothorax, which required laminoplasty and dural plasty, although nerve rootlets were killed.
Abstract: A 67-year-old woman with neurofibromatosis type 1 presented with progressive dyspnea. Radiologic evaluation and magnetic resonance imaging revealed progression of a giant meningocele associated with hydrothorax. Laminoplasty with incision of the meningocele and dural plasty was performed, although nerve rootlets were killed. Microsurgical incision of the neck of the meningocele is a favorable operation even in large meningoceles such as the present case.
TL;DR: A simplified approach to intraoperative thoracostomy tube placement is described that uses urologic techniques and protects against recurrent hydrothoraces at second-look nephroscopy, without increasing patient morbidity or length of hospital stay.
TL;DR: Peritoneoscintigraphy revealed the presence of a significant pleuroperitoneal communication, which nevertheless underwent spontaneous closure, as demonstrated by a scan repeated 3 months after CAPD was discontinued.
Abstract: Peritoneoscintigraphy is a technique with proven value in the confirmation of a pleuroperitoneal communication in continuous ambulatory peritoneal dialysis (CAPD)-related hydrothorax. Promptness of appearance and global extension of radiotracer in the thorax are scintigraphic findings that relate to the size of the diaphragmatic defects. The probability of spontaneous closure is low when the defect is large. A 71-year-old man receiving CAPD was admitted for dyspnea and maleolar edema. A chest radiograph showed a moderate right-sided pleural effusion. Peritoneoscintigraphy revealed the presence of a significant pleuroperitoneal communication, which nevertheless underwent spontaneous closure, as demonstrated by a scan repeated 3 months after CAPD was discontinued.
TL;DR: Refractory hepatic hydrothorax can be controlled by IPS in a large number of patients but its efficacy is restricted by shunt dysfunction, the risk of encephalopathy and by its limited effect on survival.
TL;DR: A 22-week-old fetus with a severe pleural effusion and hydrops was successfully treated by long-term pleural drainage with a double basket catheter from 22 to 39 weeks of gestation.
Abstract: Fetal pleural effusions can sometimes be detected before birth with ultrasonography. Intervention may be warranted when there is a condition that results in hydroplastic lung and/or fetal hydrops. A 22-week-old fetus with a severe pleural effusion and hydrops was successfully treated by long-term pleural drainage with a double basket catheter from 22 to 39 weeks of gestation.
TL;DR: A 51‐year‐old woman suffering from dyspnoea and refractory bilateral pleural effusions is discussed and radiation‐induced constrictive pericarditis should be considered if there is an unexplained transudate effusion with a normal echocardiogram.
Abstract: A 51-year-old woman suffering from dyspnoea and refractory bilateral pleural effusions is discussed. The effusion was characterized as a transudate and cardiac decompensation and renal insufficiency were initially suspected. Diuretic agents were not effective and the patient required bilateral chest water-sealed drainage tubes for 4 months, after exclusion of neoplastic infiltration, collagen disease and other cardiac disorders. On echocardiogram, cardiac function and other findings were almost normal, except for shortening of deceleration time in transmitral flow velocity. To evaluate the reduced diastolic compliance, cardiac catheterization was performed, and revealed an elevated pressure in the right ventricle with a dip-and-plateau pattern, and constrictive pericarditis was diagnosed. The hydrothorax resolved after pericardiectomy and symptoms were alleviated. Three and a half years after surgery, the patient is well and taking only oral diuretics. The underlying mechanism of cardiac disorder appears to have been mixed restriction and constriction due to irradiation of her chest for breast cancer 13 years ago. Because the echocardiogram was within normal limits, the diagnosis was delayed. Radiation-induced constrictive pericarditis should be considered if there is an unexplained transudate effusion with a normal echocardiogram.
TL;DR: This is the first case report of a distinct pathological process, i.e. amyloidosis, involving the diaphragm associated with a peritoneo-pleural communication causing massive hydrothorax at the onset of peritoneal dialysis.
Abstract: Hydrothorax secondary to trans-diaphragmatic fluid leakage through a peritoneo-pleural communication is an occasional, potentially serious complication of peritoneal dialysis. The etiology of this condition is not clear, being thought to be due either to congenital or acquired diaphragmatic fenestrations or acquired scarcity of muscle fibers in the tendinous part of the diaphragm which are compounded by increased intra-abdominal pressure during the dwell period of peritoneal dialysis. We report a 54-year-old woman who developed irreversible acute renal failure from adjuvant chemotherapy for ovarian cancer previously resected surgically. Three days after the onset of continuous ambulatory peritoneal dialysis, she developed acute respiratory distress associated with a massive right hydrothorax secondary to a peritoneo-pleural communication demonstrated by scintigraphy. At autopsy 2 weeks later, systemic amyloidosis was surprisingly found and histologic examination of the right hemidiaphragm showed the presence of amyloid, among sparse muscle fibers. This is the first case report of a distinct pathological process, i.e. amyloidosis, involving the diaphragm associated with a peritoneo-pleural communication causing massive hydrothorax at the onset of peritoneal dialysis.
TL;DR: This is the largest series of video-assisted thoracoscopic surgery treated pleuroperitoneal fistulae yet available and shows the usefulness of this approach in both closing the defect and producing an effective pleurectomy to prevent recurrence.
Abstract: Background/Aims: Hydrothorax is a complication of continuous ambulatory peritoneal dialysis (CAPD) occurring due to pleuroperitoneal fistulae. Several treatments exist with no consensus as to best management. We report on the largest series of video-assisted thoracoscopic surgery (VATS) treated pleuroperitoneal fistulae yet available. Methods: Between 1995 and 2000, we treated 6 CAPD patients for acute right hydrothoraces using VATS. Data pertaining to size and sterility of hydrothoraces, presence of diaphragmatic defects, surgical procedures performed, morbidity and return to CAPD were obtained. Results: Hydrothoraces were drained in all patients and there were no significant growths on subsequent culture. Fistulae were directly identified and closed in three patients. In the remaining patients, endoclips were placed across the base of small diaphragmatic blebs (the presumed site of communication). Parietal pleurectomy was performed uneventfully in all patients. There was no morbidity, all patients returned to haemodialysis and there have been no recurrences. Conclusion: Pleuroperitoneal fistulae produce symptomatic hydrothoraces in CAPD patients. A variety of approaches to the problem have been described. This is the largest series of VATS available and shows the usefulness of this approach in both closing the defect and producing an effective pleurectomy to prevent recurrence.
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TL;DR: A 53-year-old woman who suffered a hydrothorax induced by a central venous catheter which had been placed to facilitate total parenteral nutrition suddenly developed dyspnea and tachycardia 21 days after the insertion of the catheter.
Abstract: We report herein a case of 53-year-old woman who suffered a hydrothorax induced by a central venous catheter which had been placed to facilitate total parenteral nutrition. The central venous catheter was inserted into the superior vena cava through the right subclavian vein. Chest X-ray film after insertion revealed proper position of the tip. She suddenly developed dyspnea and tachycardia due to right-sided hydrothorax 21 days after the insertion of the catheter. Chest X-ray showed massive pleural effusion in the right thorax, and the catheter tip inadvertently turned upward. The continuous mechanical force of the catheter tip against the SVC wall was considered to be the cause of this life-threatening delayed hydrothorax.
01 Oct 2002
TL;DR: The case of a 36 old woman with a right massive hydrothorax resulting from Controlled Ovarian Hyperstimulation (COH) for infertility and the serum estradiol levels during COH were monitored and were slightly higher than the COH alarm threshold and the patient was not pregnant.
Abstract: We describe the case of a 36 old woman with a right massive hydrothorax resulting from Controlled Ovarian Hyperstimulation (COH) for infertility. This complication is defined as Ovarian Hyperstimulation Syndrome (OHSS) which usually includes abdominal pain, nausea and ascites, rarely involving the respiratory apparatus. The usual determining factors of OHSS are the presence of high serum estradiol levels and pregnancy. In the case that we describe the serum estradiol levels during COH were monitored and were slightly higher than the COH alarm threshold and the patient was not pregnant.
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TL;DR: La distinction entre les deux syndromes semble inutile, car seule l’ablation de the tumeur guerit les epanchements.
Abstract: Resume Le syndrome de Demons-Meigs (DM) typique associe un fibrome ovarien, un hydrothorax et une ascite, ces deux derniers disparaissant grâce a l’ablation de la tumeur. Le syndrome de DM atypique ou pseudo-syndrome de DM se produit quand une masse pelvienne autre qu’un fibrome ovarien est present avec hydrothorax et ascite. Ces deux syndromes doivent etre evoques chez une patiente presentant une ascite associee a un hydrothorax. Notre observation concerne une patiente de 50 ans presentant un syndrome de DM atypique (epanchement pleural isole et fibrome uterin). La distinction entre les deux syndromes semble inutile, car seule l’ablation de la tumeur guerit les epanchements.
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TL;DR: Observation data on systemic AL-amiloidosis with primary lesion of lungs and vessels (a false hemorrhagic syndrome, ischemic insult in the region of middle cerebral artery) and lesions of kidneys and heart became of minor significance.
Abstract: Here is an observation data on systemic AL-amiloidosis with primary lesion of lungs and vessels (a false hemorrhagic syndrome, ischemic insult in the region of middle cerebral artery). At the same time lesions of kidneys and heart became of minor significance. Amiloid lesion of lungs was characterized by unusual combination of symptoms: a galloping hydrothorax, a vast focus in the consolidation of pulmonary tissue with focuses of calcification, relapsing pneumothorax.
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TL;DR: Combination of IFN γ and TNF α examination provides useful assistant means for the discrimination diagnosis between tuberculous hydrothorax and carcinomatous hydroTHorax so this method has important clinic value.
Abstract: Objective Investigating the value of IFN γ and TNF α examination in the discrimination diagnosis of tuberculous hydrothorax and carcinomatous hydrothorax.Method Sandwitch double antibodies ELISA method.Results There are marked differences between tuberculous hydrothorax and carcinomatous hydrothorax in terms of IFN γ and TNF α contents.Sensitivity of the two indicators in the diagnosis of tuberculous is 91.1% and 85.3% respectively,Spcecficity of the two indicators are 86.6% and 83.3% respectively,And at the same time the positive rate detected is 85.3%.Conclusion Combination of IFN γ and TNF α examination provides useful assistant means for the discrimination diagnosis between tuberculous hydrothorax and carcinomatous hydrothorax so this method has important clinic value.
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TL;DR: Nine patients who were detected in their department during the nine-year period from 1991-2000 with the finding of pneumoperitoneum where perforation of the digestive tract was not proved are presented.
Abstract: The authors present an account on 9 patients who were detected in their department during the nine-year period from 1991-2000 with the finding of pneumoperitoneum where perforation of the digestive tract was not proved. In 4 of them (44%) conservative treatment was used, in the remaining 5 patients (56%) the condition called for surgical revision. The latter was made as an acute operation in four patients because of signs of peritoneal irritation, in one only after 4 days because of suspected tumours intestinal disease. As to the site of the assumed source of the non-perforation pneumoperitoneum we included 6 of them into the group abdominal area, (1x pneumatosis cystoides intestinalis, 1x aerogenic infection from a perforated abscess of the right liver lobe, 2x microtraumas of the wall of the cardio-esophageal transition with massive vomiting, 1x microtraumas of the lesser curvature of the stomach during extreme distension of the stomach after incorrect intubation and resuscitation, 1x passage of gas through the inflamed distended colonic wall in colitis), two patients into the thoracic area (1x in conjunction with pneumothorax, 1x with hydrothorax), 1 patient in the urogenital area (by the gynaecological route after repeated coitus and orogenital practices). The authors summarize on the basis of data in the literature and their own experience diagnostic and therapeutic possibilities of this relatively rare finding.
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TL;DR: In a fetus with a pleural effusion and hydrops fetalis, normal like echogenic view of the affected side lung and lung expansion during aspiration without any signs of fetal distress are good prognostic signs and performing a single thoracentesis could be the first choice of treatment.
Abstract: A case with a pleural effusion and hydrops fetalis has been presented. Good outcome had been achieved by a single thoracentesis and a healthy baby was delivered at the 39th week of pregnancy. In a fetus with a pleural effusion and hydrops fetalis, normal like echogenic view of the affected side lung and lung expansion during aspiration without any signs of fetal distress are good prognostic signs. We believe that in such conditions performing a single thoracentesis could be the first choice of treatment, which is a less complicated and traumatic method than thoraco-amniotic shunting. Key Words: Single thoracentesis, Fetal hydrothorax