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1
Shaik, Imam H., Bindu Gandrapu, Fernando Gonzalez-Ibarra, David Flores, Jyoti Matta, and Amer K. Syed. "Silicone Breast Implants: A Rare Cause of Pleural Effusion." Case Reports in Pulmonology 2015 (2015): 1–3. http://dx.doi.org/10.1155/2015/652918.
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Pleural effusions are one of the rarest complications reported in patients with silicone gel filled breast implants. The silicone implants have potential to provoke chronic inflammation of pleura and subsequent pulmonary complications such as pleural effusion. Herein, we report a 44-year-old female who presented with left sided pleural effusion, six weeks after a silicone breast implantation surgery. The most common infectious, inflammatory, and malignant causes of pleural effusion were excluded with pleural fluid cytology and cultures. With recurrent effusion in the setting of recent surgery, the chemical reaction to silicone breast implants was sought and exploration was performed which revealed foreign body reaction (FBR) to silicone material. The symptoms dramatically improved after the explantation.
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Allama, Amr M., Dalia H. Abou-Elela, and Islam M. Ibrahim. "Pleural and serum markers for diagnosis of malignant pleural effusion." Asian Cardiovascular and Thoracic Annals 28, no. 9 (August 2, 2020): 560–65. http://dx.doi.org/10.1177/0218492320948311.
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Background Differentiation between benign and malignant exudative pleural effusion remains a clinical challenge. Recently, several markers have been reported to increase the diagnostic accuracy of malignant pleural effusion, with controversial results. Methods Patients with exudative pleural effusion were divided into 2 groups: a malignant pleural effusion group (39 patients) diagnosed by malignant cells in pleural fluid cytology or by malignant infiltration of the pleura on pleural biopsy, and a benign pleural effusion group (51 patients) with neither malignant cells in pleural fluid cytology nor malignant infiltration of the pleura on pleural biopsy. Matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 were determined in both serum and pleural fluid samples, using commercially available enzyme-linked immunosorbent assay kits. Results The etiology of malignant pleural effusion in the malignant group was breast cancer in 43.6% and bronchogenic carcinoma in 25.6%. There was a statistically significant difference between the 2 groups regarding sex, with more males in the benign group. There was no significant difference between groups regarding age. The median levels of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 were higher in the malignant group than in the benign group, and the differences were highly significant in both pleural fluid ( p < 0.001) and serum ( p < 0.001). Conclusion Matrix metaloproteinase-9 and tissue inhibitor of metalloproteinase-1 in serum and pleural fluid samples might be valuable markers for differentiating benign from malignant pleural effusions.
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Adams, Tracy M., Nadia B. Kunzier, Martin R. Chavez, and Anthony M. Vintzileos. "Ultrasound-Guided Retrieval and Position Replacement of a Dislodged Fetal Pleuro-Amniotic Shunt: A Novel Approach for a Known Complication of Feto-Amniotic Shunting." Fetal Diagnosis and Therapy 39, no. 1 (February 6, 2015): 78–80. http://dx.doi.org/10.1159/000371576.
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Untreated fetal pleural effusion can cause significant perinatal morbidity and mortality. Treatment of pleural effusions with pleuro-amniotic shunting has been shown to improve outcomes. Pleuro-amniotic shunting is associated with complications including ruptured membranes, preterm labor and shunt dislodgement into either the amniotic cavity or the fetal thorax. Shunt dislodgement into the thoracic cavity can cause prenatal complications from the shunt itself or may necessitate neonatal surgery for removal. We present a case where a novel ultrasound-guided technique was used to replace the dislodged pleural shunt in utero, thereby effectively draining the effusion while simultaneously obviating the need for neonatal surgery and decreasing possible perinatal complications.
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Anand, Kartik, Shashank Cingam, and Prakash Peddi. "Recurrent Malignant Melanoma Presenting as Isolated Pleural Metastases in a Patient with Chronic Lymphocytic Leukemia." Case Reports in Oncology 10, no. 1 (January 19, 2017): 86–90. http://dx.doi.org/10.1159/000455827.
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Isolated pleural metastasis with pleural effusion is a rare occurrence in malignant melanoma. We report an unusual case of a patient with chronic lymphocytic leukemia (CLL) and recurrent pleural effusions. The pleural fluid cytology and immunohistochemistry profile were consistent with the diagnosis of CLL. However, chemotherapy with pentostatin, cyclophosphamide, and rituximab did not result in any meaningful clinical response. A video-assisted thoracoscopic surgery and biopsy of the affected nodular parietal layer of the pleura were consistent with malignant melanoma. Our case underlines the importance of having a suspicion for secondary causes of effusion in patients with CLL. We briefly discuss the mechanisms of an increased incidence of secondary cancers in CLL and the diagnosis of isolated pleural metastases in malignant melanoma.
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Cakir, Ebru, Funda Demirag, Mehtap Aydin, and Yurdanur Erdogan. "A review of uncommon cytopathologic diagnoses of pleural effusions from a chest diseases center in Turkey." CytoJournal 8 (July 16, 2011): 13. http://dx.doi.org/10.4103/1742-6413.83026.
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Background: After pneumonia, cancer involving the pleura is the leading cause of exudative pleural effusion. Cytologic examination of pleural effusions is an important initial step in management of malignant effusions. The aim of this study is to evaluate the spectrum of uncommon malignant pleural effusions in a chest disease center in Turkey. Materials and Methods: A retrospective study of samples of pleural effusions submitted to Ataturk Chest Diseases and Chest Surgery Education and Research Hospital Department of Pathology between March 2005 and November 2008 was performed. Results: Out of a total of 4684 samples reviewed 364 (7.8%) were positive for cancer cells. Of the malignant pleural effusions 295 (81%) were classified as adenocarcinoma or carcinoma not otherwise specified (NOS). Pleural effusion specimens revealing a diagnosis other than adenocarcinoma/carcinoma NOS were: 32 (8.8%) malignant mesotheliomas, 14 (3.8%) small cell carcinomas, 13 (3.5%) hematolymphoid malignancies and 10 (2.7%) squamous cell carcinoma. Hematolymphoid malignancies included non- Hodgkin lymphoma (diffuse B large cell lymphoma, mantle cell lymphoma), multiple myeloma, chronic myeloid leukemia, and acute myeloid leukemia. Conclusions: Despite that adenocarcinoma is the most common cause of malignant pleural effusions, there is a significant number of hematological and non-hematological uncommon causes of such effusions. Cytopathologists and clinicians must keep in mind these uncommon entities in routine practice for an accurate diagnosis.
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Pranita, Ni Putu Nita. "Diagnosis dan tatalaksana terbaru penyakit pleura." Wellness And Healthy Magazine 2, no. 1 (February 3, 2020): 69–78. http://dx.doi.org/10.30604/well.58212020.
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Pleural effusion is a common problem. Pleural effusion developed as a sequel to the underlying disease process, including pressure/volume imbalance, infection, and malignancy. In addition to pleural effusion, persistent air leak after surgery and bronchopleural fistula remain a challenge by a physician. An understanding of the pleural disease, including its diagnosis and management, has made an extraordinary step. The introduction of molecular detection of organism-specific infections, risk stratification, and improvement in the non-surgical treatment of patients with pleural infection are all within reach and maybe the standard of care shortly. This article discusses the role of existing techniques, and some of the more recent ones, which are now available for establishing the diagnosis of pleural disease. The initial approach to diagnosis usually begins by distinguishing between transudates and exudates, based on the concentration of protein and lactate dehydrogenase (LDH) in pleural fluid. The exact role of amylase and LDH can provide additional information towards the differential diagnosis of various exudative pleural effusions. With newer cytochemical staining techniques in pleural fluid, diagnostic results of malignant pleural effusion can increase by up to 80%. Ultrasound (US) and thoracic computed tomographic (CT) scans have further improved the diagnosis of undiagnosed pleural effusion. The reappearance of thoracoscopy as the latest diagnostic and therapeutic tool (e.g., Pleurodesis) for undiagnosed or recurrent pleural effusions. Management of malignant pleural effusion continues to develop with the introduction of tunneled pleural catheters and chemical pleurodesis procedures. Advances in the diagnostic and therapeutic evaluation of pleural disease and what appears to be an increasing multidisciplinary interest in a doctor managing patients with pleural disease.
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Soong, Laura C., and Richard M. Haber. "Yellow Nail Syndrome Presenting With a Pericardial Effusion: A Case Report and Review of the Literature." Journal of Cutaneous Medicine and Surgery 22, no. 2 (October 25, 2017): 190–93. http://dx.doi.org/10.1177/1203475417738970.
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Yellow nail syndrome (YNS) is a constellation of clinical findings including at least 2 of the 3 features of thickened yellow nails, respiratory tract involvement, and lymphedema. We report the case of a middle-aged man presenting with dystrophic, thickened yellow nails; an idiopathic pericardial effusion in the absence of pleural effusion(s); and unilateral apical bronchiectasis found on computed tomography of the chest. This represents a unique presentation of YNS as the first report of a patient with YNS and a pericardial effusion in the absence of pleural effusions and lymphedema and is the 11th case report of YNS with pericardial effusion.
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Stevic, Ruza, Nikola Colic, Slavisa Bascarevic, Marko Kostic, Dejan Moskovljevic, Milan Savic, and Maja Ercegovac. "Sonographic Indicators for Treatment Choice and Follow-Up in Patients with Pleural Effusion." Canadian Respiratory Journal 2018 (October 30, 2018): 1–6. http://dx.doi.org/10.1155/2018/9761583.
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Aim. The aim of this study was to evaluate the role of thoracic sonography in treatment of pleural effusions and to identify sonographic indicators for surgical intervention. Materials and Methods. This study included 378 patients with pleural effusions. US characteristics of effusions as the echo structure and pleural thickening were analyzed. Regarding the US finding, the diagnostic or therapeutic procedure was performed. Results. The study included 267 male and 111 female patients, an average of 56.7 years. Infection was the most frequent cause of effusion. Two hundred sixty-nine patients had loculated and 109 free pleural effusion. Most frequent echo structure of loculated effusion was complex septate, whereas free effusion was mostly anechoic. Successful obtaining of the pleural fluid without real-time guidance was in 88% and under real-time guidance in 99% patients (p<0.012). There was no significant difference in success rate between free and loculated effusion and regarding the echo structure (p=0.710 and 0.126, respectively). Complete fluid removal after serial thoracentesis or drainage was achieved in 86% patients. Forty-five patients with significantly thicker pleural peel and impairment of the diaphragmatic function than remaining of the group (p<0.001) underwent surgery. Open thoracotomy and decortication was more frequently performed in patients with completely fixed diaphragm and complex, dominantly septated effusions. There is no significant difference in US parameters comparing to patients underwent VATS, but the number of VATS is too small for valid conclusion. Conclusion. Thoracic sonography is a very useful tool in the evaluation of clinical course and treatment options in patients with pleural effusions of a different origin.
9
Reynolds, SP, AR Gibbs, R. Weeks, H. Adams, and BH Davies. "Massive pleural effusion: an unusual presentation of Castleman's disease." European Respiratory Journal 5, no. 9 (October 1, 1992): 1150–53. http://dx.doi.org/10.1183/09031936.93.05091150.
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Giant lymph node hyperplasia (Castleman's Disease) is a rare cause of pleural effusion. We report the case of a 51 yr old West Indian male, who presented with a recurrent massive pleural effusion, due to a tumour arising from the pleura. He underwent parietal pleurectomy and subtotal excision of the tumour. Histological analysis of the specimen showed the features of multicentric Castleman's disease. Nine months following surgery he remains well, with no recurrence of the effusion.
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Trivedi, Surbhi B., and Matthew Niemeyer. "Treating Recurrent Pleural Disease: A Review of Indications and Technique for Chemical Pleurodesis for the Interventional Radiologist." Seminars in Interventional Radiology 39, no. 03 (June 2022): 275–84. http://dx.doi.org/10.1055/s-0042-1754349.
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AbstractPleural space diseases such as recurrent pleural effusion and pneumothorax inflict a significant symptomatic burden on patients. Guidelines and studies are available to guide best practices in the setting of refractory effusions, mostly in the setting of malignancy, and recurrent pneumothorax. Less data is available to guide management of refractory transudative effusions. Recurrent pleural effusions can be treated with tunneled pleural catheters or catheter-based pleurodesis. While refractory transudative effusions can benefit from tunneled pleural catheter, this is an area of ongoing research. Regarding recurrent pneumothorax, video-assisted thoracoscopic surgery (VATS) pleurodesis using mechanical or laser/argon beam coagulation is the most effective means of preventing recurrence. Catheter based pleurodesis, a less invasive means of administering chemical sclerosant via percutaneous thoracostomy tube, is only used when surgery is not an option. However, both approaches induce inflammation of the pleural space, resulting in adherence of the parietal and visceral pleura to prevent fluid or air re-accumulation. This article will discuss catheter based chemical pleurodesis geared toward the interventional radiologist, including a review of disease processes and indications, technique, and strategies to mitigate complications as well as a literature review comparing percutaneous chemical pleurodesis to other therapies.
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Huang, Chienhsiu. "The Differential Diagnosis of Bilateral Pleural Effusion and Multiple Mediastinal Lymphadenopathies Includes Kikuchi-Fujimoto Disease." Journal of Investigative Medicine High Impact Case Reports 8 (January 2020): 232470962093342. http://dx.doi.org/10.1177/2324709620933422.
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Kikuchi-Fujimoto disease is an uncommon lymphohistiocytic disorder that frequently presents with acute or subacute clinical disease course. Cervical lymphadenopathy is the most common involved lymph node. Very rare cases of pathologic diagnosis of Kikuchi-Fujimoto disease with bilateral pleural effusion and multiple mediastinal lymphadenopathies have been reported in the literature. In this article, we report the case of a 60-year-old male presented with bilateral pleural effusion and multiple mediastinal lymphadenopathies. He received video-assisted thoracoscopic surgery of the right pleura and thoracoscopic excision of the mediastinal lymph node. The pathologic findings from the lymph node and pleura were compatible with Kikuchi-Fujimoto disease. He was treated with oral hydroxychloroquine and oral prednisolone. A computed tomography scan of the chest 4 months later showed regressive mediastinal lymphadenopathy and bilateral pleural effusion. Our case is a first reported case of Kikuchi-Fujimoto disease diagnosis by the pathology of the lymph node and pleura in the literature. Results from our case suggest that Kikuchi-Fujimoto disease should be included in the differential diagnosis of bilateral pleural effusion and multiple mediastinal lymphadenopathies.
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Din, Iqtidar-Ud, Muhammad Abdur Rauf, Yasir Arafat, Bilal Mustafa, and Tanveer Ahmad. "Clinical Presentation of Pleural Effusion Among Patients after CABG and its Prevalence." Pakistan Journal of Medical and Health Sciences 16, no. 6 (June 30, 2022): 860–62. http://dx.doi.org/10.53350/pjmhs22166860.
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Objective: Pleural effusion often occurs after CABG. Usually, this effusion is slight and asymptomatic. There is also high symptomatic effusion, but in a small percentage of patients. Pleural effusion after CABG may be associated with significant morbidity and prolonged hospital stay. Early diagnosis and treatment can reduce morbidity of patients and extent of hospital stay. Aim: The aim of the study is to determine the risk factors and the severity of pleural effusion in patients after CABG. Place and Duration: In the Cardiology department of Qazi Hussain Ahmed Medical Complex, Nowshera for six-months duration from July 2020 to December 2020. Material and methods: The study was held among 120 patients after meeting the inclusion criteria and selected for the study. Patients were included in study population before referral for CABG from QHAMC to multicenters of Khyber Pakhtunkhwa. Their records were closely followed during admissions for CABG and post CABG and also assessed on various follow up visits. The study procedure was described to the patient and informed consent was obtained. Demographics, name, age, gender, surgery details, comorbidities such as COPD, EF and smoking were recorded on the attached form. The patients stayed in the intensive cardiac surgery unit for at least 7 days. The presence and severity of pleural effusion was assessed on the CXR. A chest x-ray was done on daily basis and evaluated by a chest specialist in the morning round. The amount of effusion in CXR was classified as follows: low effusion covering less than half of the chest, high effusion covering more than half of the chest. Possible risk factors for the development of pleural effusion in post-CABG patients have been reported. Results: The majority 99(82.5%) of the 120 subjects who had pleural effusion done with CABG were male. The patients mean age was 55.28 ± 10.47 years. Most patients 93(77.5%) had left pleurotomy. LIMA harvesting was reported in 98(81.7%) of patients. Most patients 100(83.3%) had left sided pleural effusions and 5(4.2%) had right sided and bilateral pleural effusions in 15(12.5%) of cases. A total of 102 patients (85%) had low (less than half of the chest) pleural effusion and large symptomatic pleural effusion in 18(18%) (more than half of the chest). 104 patients (86.7%) required pleural aspiration. Most of the patients 110(91.7%) had decreased serum albumin. Of the patients requiring effusion aspiration, 46 (38.3%) had dyspnea, 18 (15.0%) cough, 34 (28.3%) ABGs abnormalities, and 8 (7.7%) had atelectasis. Preoperative EF was normal in 80 (66.7%) patients, but poor EF was present in 50 (33.3%) patients on the 7th postoperative day. Conclusion: A slight left-sided effusion developed in the majority of patients after CABG. There was also large size of pleural effusion, but occurs in small extent. The effusion mainly causes some respiratory symptoms that require pleural aspiration. LIMA harvesting, pleurotomy and hypoalbuminemia were the main risk factors for pleural effusion in patients after CABG. Keywords: CABG = coronary artery bypass grafting, LIMA = Left internal mammary artery, CXR = chest X-ray, ICU = intensive care unit, COPD = chronic obstructive pulmonary disease and EF = ejection fraction.
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Bhaskar, K., K. Devanandan, Jitendar Kala Jain, Tella Krishna, and P. Gongati. "Unilateral Transudative Pleural Effusion due to rare Cause – A Case Report." Indian Journal of Cardiovascular Disease in Women 7 (October 17, 2022): 149–52. http://dx.doi.org/10.25259/mm_ijcdw_409.
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Transudative pleural effusions are characterized by low protein and lactate dehydrogenase according to Light’s criteria. Common causes are congestive cardiac failure, nephrotic syndrome, liver cirrhosis, and protein-losing enteropathy. Constrictive pericarditis is a rare cause of transudative pleural effusion. It can cause bilateral or unilateral recurrent effusions and chylothorax rarely. Common causes of constrictive pericarditis include infections such as viruses and tuberculosis, radiation, and cardiac surgery. We present a treated case of pulmonary tuberculosis presenting with massive, left-sided, and transudative pleural effusion due to constrictive pericarditis diagnosed by computed tomography scan and 2D echo with classical findings. Incidental findings were internal jugular vein thrombus and right lower lobar pulmonary embolus. This case highlights the atypical presentation of constrictive pericarditis as unilateral pleural effusion. A proper history with a high index of suspicion is essential in the workup of constrictive pericarditis which can be cured by pericardiectomy.
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Wagh, Pankaj Wagh, and Ankit Rangari. "The title you have entered, A Case of Pleural Effusion Secondary to Covid-19, is exactly the same as that of another manuscript already submitted by Pankaj Wagh Wagh." ECS Transactions 107, no. 1 (April 24, 2022): 16441–49. http://dx.doi.org/10.1149/10701.16441ecst.
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Normal radiological discoveries of Covid 19 disease incorporatereciprocal ground glass opacities in lower flaps with a fringecirculation. Pleural radiation is viewed as an uncommon indication ofCovid 19 contamination. Pleural effusion can be divided intotransudative & exudative pleural effusions. Transudative pleuraleffusion occurs due to cirrhosis, heart failure, post open heart surgery& pulmonary embolism whereas an exudative pleural effusion aretriggered by pulmonary bacterial pneumonia or tuberculosis, cancer,inflammatory disorders such as pancreatitis, lupus, rheumatoidarthritis, post-cardiac injury syndrome, chylothorax (due to lymphaticobstruction), hemothorax (blood in the pleural space), and benignasbestos pleural effusion. This two types of pleural effusion can beidentified by measurement of the pleural fluid protein and lacticdehydrogenase (LDH). When the patient's serum total protein isnormal but the pleural fluid protein is less than 25g/L, the fluid isclassified as a transudate. The fluid is an exudate if the protein contentof the pleural fluid is greater than 35g/L.We'll look at the case of a 55-years-old male farmer with complains of breathlessness, cough, feverand left sided chest pain since 3 weeks. He had a history of Covid 19 Positive status 1 month back for which he took medications based onCovid 19 guidelines and HRCT score was 12/25. High amounts of Creactive protein & ferritin were discovered in laboratory tests. ChestX-ray & CT scan identified a massive left sided pleural effusion.Keywords: SARS-COV-2, Pleural Effusion, LDH,Lymphadenopathy.Int
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Little, Amy A., Michele Steffey, and Marc S. Kraus. "Marked Pleural Effusion Causing Right Atrial Collapse Simulating Cardiac Tamponade in a Dog." Journal of the American Animal Hospital Association 43, no. 3 (May 1, 2007): 157–62. http://dx.doi.org/10.5326/0430157.
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A 16-month-old, female German shepherd dog was presented with severe bicavitary effusions. A diaphragmatic hernia was diagnosed by thoracic radiography. An echocardiogram performed prior to surgical repair of the hernia revealed signs of cardiac tamponade, with right atrial collapse, in the absence of pericardial effusion. Right atrial collapse was presumed to be secondary to severe pleural effusion. At surgery, no pericardial disease was identified. Surgical correction of the diaphragmatic hernia resulted in resolution of the pleural and peritoneal effusions. Follow-up echocardiography demonstrated resolution of the signs of cardiac tamponade.
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Daula, Muhammad Imran Hameed. "MALIGNANT PLEURAL EFFUSION." Professional Medical Journal 22, no. 06 (June 10, 2015): 828–32. http://dx.doi.org/10.29309/tpmj/2015.22.06.1257.
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Objectives: To assess the role of video assisted thoracoscopic talc pleurodesisin the surgical management of malignant pleural effusions by comparing this procedure withpleurodesis via talc slurry through an intercostals chest tube. Design: Prospective analysisof fifty patients with malignant pleural effusion which were divided into two groups. Groupone included twenty patients while group two included thirty patients. Setting: Department ofThoracic Surgery and the Department of Oncology, Combined Military Hospital, Rawalpindi.Period: October 2008 till November 2010. Subjects: Fifty patients of malignant pleural effusionwere included in the study. They were divided into two groups. Group one included twentypatients whereas group two included thirty patients. Interventions: Patients in group onewere subjected to videoassisted thoracoscopic talc pleurodesis. Patients in group two weresubjected to pleurodesis via talc slurry through an intercostal drainage tube. RESULTS: Fiftypatients were included in the study. The mean follow up time was 5.7 months for group oneand 5.5 months for group two. Out of the twenty patients in group one 95% had successfulpleurodesis (defined as satisfactory pleurodesis three months post procedure). Adverse effectsincluded fever in three patients (15%), empyema in one patient (5%) and malignant invasionof the scar in one patient (5%). Out of the thirty patients in group two 70% had successfulpleurodesis. Adverse effects included fever in five patients (17%), empyema in one patient (3%),and pulmonary infection in one patient (3%). No mortalities occurred during the procedures ineither of the group. Conclusions: Videoassisted thoracoscopic talc pleurodesis is a safe andeffective method of producing reliable pleurodesis in patients with malignant pleural effusion. It issuperior to pleurodesis via talc slurry through an intercostal drainage tube in terms of producinga reliable and complete pleurodesis. It should be performed early in patients presenting withmalignant pleural effusions to avoid the risk of respiratory failure, this being directly linked to thegeneral and respiratory status of the patients at the time of the procedure.
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Zhang, Tianyu, Cuicui Wu, Zhongtao Li, Yan Ding, Lijuan Wen, and Li Wang. "CAMPO Precision128 Max ENERGY Spectrum CT Combined with Multiple Parameters to Evaluate the Benign and Malignant Pleural Effusion." Journal of Healthcare Engineering 2021 (February 26, 2021): 1–11. http://dx.doi.org/10.1155/2021/5526977.
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The emergence of energy spectrum CT provides greater diagnostic value for clinical practice. Its advantage is that it can provide more functional imaging parameters and accurate image information for clinical practice, which represents a mainstream direction of CT technology development at present. This paper mainly studies the clinical trial of CAMPO Precision128 Max ENERGY spectrum CT combined with multiple parameters to evaluate the benign and malignant pleural effusion. This paper analyzes the principle and key performance parameters of energy spectrum CT imaging, the etiology of pleural effusion, and its conventional diagnostic methods and uses energy spectrum CT to detect the benign and malignant pleural effusion. In this paper, two groups of patients with different types of pleural effusions were scanned by line spectrum chest CT scans, and energy spectrum analysis software was used to measure and calculate the CT values of conventional mixed energy values of ROI of patients with pleural effusions. For the CT value and energy curve slope measurement value of different single energy keV, independent sample t-test was used to analyze and compare the two sets of data, and finally it has been found out that the two sets of data were similar. According to the experimental results, the curves of energy spectrum of the two groups of data are similar in the descending curve of bow-back. The slope of energy spectrum curve in the leakage group was lower than that in the exudate group, showing statistical significance ( P < 0.05 ). The slope of energy spectrum curve K in the malignant pleural effusion group was significantly higher than that in the benign pleural effusion group, and the difference was statistically significant ( P < 0.05 ). The trend of energy spectrum curves of the two is roughly the same, while at the high energy level, part of the energy spectrum curves of the two are overlapped. The above conclusion indicates that energy spectrum CT plays a certain role in the differential diagnosis of pleural effusion. At the same time, energy spectrum CT also provides a noninvasive and rapid examination method for clinical differentiation of pleural effusion, which has certain clinical application value and prospect.
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Baral, Ravi Kumar. "Video Assisted Thoracoscopic Surgery in Exudative Pleural Effusion and its Complication Management: An Experience in a Community Hospital." Journal of Nobel Medical College 10, no. 2 (December 31, 2021): 7–10. http://dx.doi.org/10.3126/jonmc.v10i2.41568.
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Background: Exudative pleural effusions are common presentation of pleural disease. Long standing pleural effusion might complicate with loculations and cortex formation. Video assisted thoracoscopic surgery can be a useful tool for the diagnosis and the management of the complications. The aim of the study is to determine the cause and treat the complications related to the exudative pleural effusions.
Materials and Methods: It is a retrospective analysis of prospectively collected data of all patients with exudative pleural effusions subjected to surgical management. Data were collected over a period of four years in a community hospital in Kathmandu.
Results: Of 38 patients who underwent Video assisted thoracoscopic surgery only 33 were eligible for analysis. Male to female ratio was 2.3:1 with male (23) dominance. Twenty six (78.8%) had lymphocyte predominance and 23 (69.7%) had Adenosine deaminase level of more than 40 International unit in pleural fluid analysis. In histopathological examination most common finding was granulomatous inflammation 13 (39.4%), 9 (27.3%) were malignancy and 9 (27.3%) were nonspecific chronic inflammation. Of malignancies adenocarcinoma 3 (9.09%) was the most common finding, mesothelioma 2(6.06%) and 4 (12.12%) other.
Conclusion: Video assisted thoracoscopic surgery has a role to play in diagnosis of exudative pleural effusions, particularly when there is dilemma in diagnosis. Video assisted thoracoscopic surgery definitely has a role in diagnosis and treatment of the complications related to pleural effusions.
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Vargas, Francisco S., Kiyomi K. Uezumi, Fabio B. Janete, Mario Terra-Filho, Whady Hueb, Alberto Cukier, and Richard W. Light. "Acute pleuropulmonary complications detected by computed tomography following myocardial revascularization." Revista do Hospital das Clínicas 57, no. 4 (August 2002): 135–42. http://dx.doi.org/10.1590/s0041-87812002000400003.
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INTRODUCTION: Pleuropulmonary changes are common following coronary artery bypass grafting surgery performed with a saphenous vein graft, with or without an internal mammary artery. The presence of atelectasis or pleural effusions reflects the thoracic trauma. PURPOSE: To define the postoperative incidence of changes in the lung and in the pleural space and to evaluate the influence of the trauma. METHODS: Thirty patients underwent elective coronary artery bypass grafting surgery (8 saphenous vein grafts and 22 saphenous vein grafts and internal mammary artery grafts with pleurotomy). Chest tubes in the left pleural space were used in all internal mammary artery patients. On the second (day 2) and seventh (day 7) postoperative day, patients underwent a computed tomography, and pleural effusions were rated as follows: grade 0 = no fluid to grade 4 = fluid in more than 75% of the hemithorax. Atelectasis was rated as follows: laminar = 1, segmental = 3, and lobar = 10 points. RESULTS: All patients had pleural effusion or atelectasis. Between day 2 and day 7, the number of patients with effusions or atelectasis on the right side decreased (P < 0.05). The incidence of effusions on day 2 in the saphenous vein graft group (87.5%) was higher (P < 0.05) than in the internal mammary artery group (52.3%). The incidence of atelectasis in the lower right lobe decreased (P < 0.05) from 86.7% (day 2) to 26.7% (day 7). The degree of atelectasis in both sides did not differ on day 2 (P = 0.42) but did on day 7 (P < 0.0001). There was a decrease in the atelectasis from day 2 to day 7 on the right side (P < 0.001), but not on the left (P = 0.21). On day 2 there was a relationship between atelectasis and effusion on the right (P = 0.04), but not on the left (P = 0.113). CONCLUSION: The present series demonstrates that there is a high incidence of both minimal pleural effusion and atelectasis after coronary artery bypass grafting surgery, which drops on the right side from day 2 to day 7 post surgery. Factors that contribute to the persistence of changes on the left side include the thoracic trauma and the presence of chest tubes and pericardial effusion.
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Peycru, Thierry, Julien Jarry, Stéphanie Brun, Rodolphe Bodin, Antoine Schwartz, and Federico Gonzalez. "Right postoperative pleural effusion following laparoscopic appendicectomies: a case series." Annals of The Royal College of Surgeons of England 92, no. 5 (July 2010): e33-e35. http://dx.doi.org/10.1308/147870810x12699662980312.
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Pleural effusion is not a commonly reported complication of appendicectomy. In our experience, we have performed all forms of appendicitis by laparoscopy (n = 217) since August 2006. We report three consecutive cases of right postoperative pleural effusion, all of which occurred during the immediate postoperative course of a laparoscopic appendicectomy. All three patients presented a perforated appendicitis. The right postoperative pleural effusions seem to be linked to the laparoscopic approach, and can be explained by the cumulative effects of peritoneal lavage, pneumoperitoneum and Trendelenburg position. The first two cases were managed medically by intravenous antibiotic therapy. The third patient required a pleural drainage by thoracoscopy. Surgeons should be aware of this complication when operating perforated appendicitis by the laparoscopic method.
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Manglani, Ravi P., Misbahuddin Khaja, Karen Hennessey, and Omonuwa Kennedy. "Pleural Mycobacterium Avium Complex Infection in an Immunocompetent Female with No Risk Factors." Case Reports in Pulmonology 2015 (2015): 1–3. http://dx.doi.org/10.1155/2015/760614.
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Mycobacterium avium complex (MAC) infections rarely affect the pleura, accounting for 5–15% of pulmonary MAC. We report a case of MAC pleural effusion in an otherwise immunocompetent young patient. A 37-year-old healthy female with no past medical history was admitted to the hospital with two weeks of right sided pleuritic chest pain, productive cough, and fever. She was febrile, tachycardic, and tachypneic with signs of right sided pleural effusion which were confirmed by chest X-ray and chest CT. Thoracentesis revealed lymphocytic predominant exudative fluid. The patient underwent pleural biopsy, bronchoscopy with bronchoalveolar lavage, and video assisted thoracoscopic surgery (VATS), all of which failed to identify the causative organism. Six weeks later, MAC was identified in the pleural fluid and pleural biopsy by DNA hybridization and culture. The patient was started on clarithromycin, ethambutol, and rifampin. After six months of treatment, she was asymptomatic with complete radiological resolution of the effusion. The presence of lymphocytic effusion should raise the suspicion for both tuberculous and nontuberculous mycobacterial disease. Pleural biopsy must be considered to make the diagnosis. Clinicians must maintain a high index of suspicion of MAC infection in an otherwise immunocompetent patient presenting with a unilateral lymphocytic exudative effusion.
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Kotel’Nikova, L. P., S. A. Plaksin, P. L. Kudryavtsev, and L. I. Farshatova. "Pulmonary-pleural complications of pancreatitis." Grekov's Bulletin of Surgery 176, no. 3 (June 28, 2017): 28–31. http://dx.doi.org/10.24884/0042-4625-2017-176-3-28-31.
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OBJECTIVE. The authors investigated pulmonary-pleural complications of pancreatitis and evaluated results of CT examination in diagnostics and possibility of low invasive surgery in treatment of pancreaticogenic pleurisy. MATERIAL AND METHODS. A retrospective analysis was made of 156 medical histories of patients with acute pancreatitis and their results. An ultrasound examinations of the chest and CT scan were applied in order to determine lung tissue condition and presence of fluid in pleural cavities. RESULTS. The application of CT in diagnostics of pulmonary-pleural complications allowed doctors to identify an effusion in pleural cavities in 3,5-50 % patients with acute pancreatitis. The number and localization of effusions were defined more precisely. CONCLUSIONS. Mini-invasive procedures (puncture, videothoracoscopy) with examination of exudate on amylase activity and biopsy of pleura determined the causes of pleuritis. This was effective in pleritis elimination against a background of different methods of treatment of pancreatitis.
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Basu, Somprakas, Shilpi Bhadani, and Vijay K. Shukla. "A dangerous pleural effusion." Annals of The Royal College of Surgeons of England 92, no. 5 (July 2010): e53-e54. http://dx.doi.org/10.1308/147870810x12699662980637.
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Bilothorax is a rare complication of biliary peritonitis and, if not treated promptly, can be life-threatening. We report a case of a middle-aged woman who had undergone a bilio-enteric bypass and subsequently a biliary leak developed, which finally led to intra-abdominal biliary collection and spontaneous bilothorax. The clinical course was rapid and mimicked venous thromboembolism, myocardial infarction and pulmonary oedema, which led to a delay in diagnosis and management and finally death. We high-light the fact that bilothorax, although a rare complication of biliary surgery, should always be considered as a probable cause of massive effusion and sudden-onset respiratory and cardiovascular collapse in the postoperative period. A chest X-ray and a diagnostic pleural tap can confirm the diagnosis. Once detected, an aggressive management should be instituted to prevent organ failure and death.
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Pyae, Phyoe Kyaw, Rigers Cama, Andrew G. Nicholson, and Rama Vancheeswaran. "Curious case of the unexplained exudative pleural effusion." BMJ Case Reports 14, no. 9 (September 2021): e245796. http://dx.doi.org/10.1136/bcr-2021-245796.
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We report a case of a 74-year-old male patient who was referred to the respiratory clinic with an incidental finding of a left sided pleural effusion. He was initially being treated by the general practitioner for chest infection with productive cough that had limited resolution after course of oral antibiotics. At the pleural clinic, 1.5 L of serosanguineous fluid was drained and sent for diagnostics. However, the diagnosis only reached as far as idiopathic exudative effusion with lymphocytes and plasma cells. He was then referred for video-assisted thoracoscopic surgery pleural biopsy and pleurodesis. It revealed black pleura with abundant IgG4 positive cells. He is followed up in respiratory clinic where further discussion and treatment has commenced.
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Yu, Lei. "Hyperthermic intrapleural chemotherapy combined with endostar by video-assisted thoracoscopic surgery for lung adenocarcinoma with pleural dissemination." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): e17542-e17542. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e17542.
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e17542 Background: Patients with lung adenocarcinoma and malignant pleural effusions have limited life expectancy. The treatment of lung adenocarcinoma with malignant pleural effusions remains controversial. The purpose of our study is to evaluate the use of video-assisted thoracoscopy to perform hyperthermic intrapleural chemotherapy combined with Endostar (recombinant human endostatin) for disseminated pleural adenocarcinoma. Methods: From 2007 to 2010, there were 46 patients with lung adenocarcinoma and pleural dissemination undergoing thoracoscopic surgery and intrathoracic hyperthermic perfusion with chemotherapy in combination of Endostar. After thoracoscopic surgery, the hyperthermic perfusion system was set up for hyperthermic intrapleural chemotherapy. The thoracic cavity was perfused at a speed of approximately 1.8-2.3 L/min with 0.9% normal saline (4-5L), containing cisplatinum (100 mg). The intrathoracic temperature remained between 42°C to 43°C. This process of perfusion lasted for 1 hours. Following this, 2L of 0.45% saline with Endostar (30 mg) at a temperature of 30 °C was put into the pleural cavity and kept for 30 min. Results: There were no peri-operative deaths. During the hyperthermic perfusion, patient's core temperature varied from 36.3ºC and 39.3ºC and pulse from 59 beats/m and 126 beats/m. Intraoperative sinus tachycardia occurred in 2 elderly cases. No hematologic toxicity and nephrotoxicity was observed within one week after surgery. Postoperative pneumonia occurred in 1 elderly case. The median survival time was 21 months. During the follow-up period, only one patient suffered from continuing pleural effusion due to atelectasis, one elderly patient died of heart failure one year after surgery and the remaining patients were completely free from pleural effusion during the last follow-up. Conclusions: Hyperthermic intrapleural chemotherapy combined with Endostar by thoracoscopic surgery offers a safe and effective treatment for lung adenocarcinoma with pleural dissemination. It may be time-consuming, but beneficial and may have an encouraging impact on its long-term survival.
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Gowrinath, K. "Filarial pleural effusion." Annals of Thoracic Medicine 6, no. 1 (2011): 46. http://dx.doi.org/10.4103/1817-1737.74279.
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Xi, Suya, Jinhao Sun, Hongjing Wang, Qingzhe Qiao, and Xianghong He. "Diagnostic Value of Model-Based Iterative Algorithm in Tuberculous Pleural Effusion." Journal of Healthcare Engineering 2022 (February 9, 2022): 1–9. http://dx.doi.org/10.1155/2022/7845767.
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Although there are several diagnostic modalities for tuberculous pleurisy, there is still a lack of easy, cost-effective, and rapid methods for confirming the diagnosis. In order to facilitate clinicians to diagnose patients with tuberculous pleurisy at an early stage, help patients to obtain treatment early, and reduce lung damage, it is hoped that new techniques will be available in the future to help diagnose tuberculous pleurisy rapidly in the clinic. To this end, this paper investigates the problem of bidirectional consistency based on event-triggered iterative learning. Firstly, a dynamic linearized data model of TB pleurisy intelligent system is established using compact-form dynamic linearization method, and a parameter estimation algorithm of TB pleurisy data model is proposed; then, based on this data model, an output observer and a dead zone controller are designed, and an event-triggered distributed model-free iterative learning bidirectional consistency control strategy is constructed by combining with signal graph theory. In this paper, 112 patients with pleural effusion were collected, including 76 patients with confirmed or clinically diagnosed tuberculous pleural effusion and 36 patients with nontuberculous pleural effusion. Pleural effusion T-SPOT.TB, blood T-SPOT.TB, pleural effusion Xpert MTB/RIF, and pleural effusion adenosine deaminase (ADA) tests were performed before treatment in the included patients. The sensitivity of pleural effusion T-SPOT.TB was higher than that of peripheral blood T-SPOT.TB (76.32%, 58/76), pleural effusion Xpert MTB/RIF (65.79%, 50/76), and pleural effusion ADA (28.95%, 22/76); the differences were statistically significant (x2 = 14.74, 25.22, and 76.45, P < 0.01). The specificity of the Xpert MTB/RIF test for pleural effusion (100%, 36/36) was higher than that for pleural effusion T-SPOT.TB (77.78%, 28/36), peripheral blood T-SPOT.TB, and pleural effusion T-SPOT.TB. The sensitivity of the combined Xpert MTB/RIF test (64.47%, 49/76) was lower than that of the pleural effusion T-SPOT.TB alone (97.37%, 74/76).
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Khaliq, Muhammad Farhan, Muhammad Muslim Noorani, Monica Chowdhry, Hesham Mohamed, and Ashish Koirala. "Transjugular Intrahepatic Portosystemic Shunt (TIPS) in Refractory Transudative Chylothorax due to Liver Cirrhosis." Case Reports in Medicine 2020 (February 7, 2020): 1–4. http://dx.doi.org/10.1155/2020/2581040.
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Chylothorax is an infrequent type of pleural effusion, typically exudative, caused by obstruction or laceration of the thoracic duct by malignancy, trauma, or thoracic surgery. Transudative chylous pleural effusions are extremely rare. We report a case of a 63-year-old male with recurrent transudative chylothorax secondary to cirrhosis that completely resolved with transjugular intrahepatic portosystemic shunting (TIPS). Transudative chylous pleural effusion is an extremely rare entity with only a few cases reported in the literature to date. Transudative chylothorax can occur in patients with liver cirrhosis. Recognizing this association will prevent unnecessary testing and procedures. Timely diagnosis and early initiation of treatment are pivotal in preventing complications from malnutrition and infection by preventing loss of electrolytes, immunoglobulins, and T-lymphocytes.
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Kim, Jae Jun, Young Jo Sa, Deog Gon Cho, Young Du Kim, Chi Kyung Kim, and Seok Whan Moon. "Intractable Hiccup Accompanying Pleural Effusion." Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 23, no. 3 (June 2013): 357–59. http://dx.doi.org/10.1097/sle.0b013e31828e3790.
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Dunning, Joel, Mahmood Megahed, and Russell W. J. Millner. "The Frequency of Pleural Effusions after Bellovac Drainage following Coronary Bypass Grafting." Cardiovascular Surgery 11, no. 4 (August 2003): 309–12. http://dx.doi.org/10.1177/096721090301100411.
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Background: A common postoperative complication after CABG with internal mammary artery (IMA) harvest is the evolution of a pleural effusion. Our aim was to see if the intra-operative insertion of a Bellovac drain to the pleural cavity, with drainage continuing for 4-days post operation, eliminates the complication of pleural effusion. Methods: Using our computerised audit database, 500 consecutive patients were identified who had undergone CABG including at least one internal mammary graft by a single consultant at Blackpool Victoria Hospital. All these patients received Bellovac drainage for 4 days on the side of the harvested IMA. The chest X-ray reports were retrospectively collected from the hospital computer databases. The 4-day post-operative, and the 6-week post-operative films were found. In the cases where no consultant radiologist report was found J.D. reviewed the film, and any abnormalities were also reviewed by R.W.J.M. Results: Out of 500 radiographs, six patients (1.2%) died, 25 patients had no traceable record of a chest X-ray, 434 patients had an entirely normal chest X-ray and 461 patients had no effusion at 6 weeks. Six patients had a small effusion at 6 weeks, two had a moderate effusion successfully treated conservatively, and no patients had a pleural effusion that required drainage. Conclusion: In patients undergoing coronary arterial bypass grafting with Internal mammary artery harvest, the intra-operative insertion of a Bellovac drain on the side of the harvested IMA reduces the risk of postoperative pleural effusions
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Hori, Yusuke S., Toru Fukuhara, Mizuho Aoi, Kazunori Oda, and Yoko Shinno. "Extracranial glioblastoma diagnosed by examination of pleural effusion using the cell block technique: case report." Neurosurgical Focus 44, no. 6 (June 2018): E8. http://dx.doi.org/10.3171/2017.8.focus17403.
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Metastatic glioblastoma is a rare condition, and several studies have reported the involvement of multiple organs including the lymph nodes, liver, and lung. The lung and pleura are reportedly the most frequent sites of metastasis, and diagnosis using less invasive tools such as cytological analysis with fine needle aspiration biopsy is challenging. Cytological analysis of fluid specimens tends to be negative because of the small number of cells obtained, whereas the cell block technique reportedly has higher sensitivity because of a decrease in cellular dispersion. Herein, the authors describe a patient with a history of diffuse astrocytoma who developed intractable, progressive accumulation of pleural fluid. Initial cytological analysis of the pleural effusion obtained by thoracocentesis was negative, but reanalysis using the cell block technique revealed the presence of glioblastoma cells. This is the first report to suggest the effectiveness of the cell block technique in the diagnosis of extracranial glioblastoma using pleural effusion. In patients with a history of glioma, the presence of extremely intractable pleural effusion warrants cytological analysis of the fluid using this technique in order to initiate appropriate chemotherapy.
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Vu, Huan N., Frank W. Jenkins, Steven H. Swerdlow, Joseph Locker, and Michael T. Lotze. "Pleural effusion as the presentation for primary effusion lymphoma." Surgery 123, no. 5 (May 1998): 589–91. http://dx.doi.org/10.1067/msy.1998.88087.
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Rahman, Md Shakibur, Probir Kumar Sarkar, Khandakar Ashikur Zaman, Nabila Akand, and Md Kamruzzaman. "Intrapleural Streptokinase in Parapneumonic / Complicated Pleural Effusion/Empyema: Experience in Dhaka Shishu (Children) Hospital." Bangladesh Journal of Child Health 44, no. 2 (December 31, 2020): 104–8. http://dx.doi.org/10.3329/bjch.v44i2.51135.
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Background: Parapneumonic effusion/complicated pleural effusion/empyema thoracis in children causes significant morbidity. Standard treatment of pleural effusion includes tube drainage and antibiotics. But the tube drainage often fails. Intrapleural Streptokinase has been used in empyema thoracis as well as complicated pleural effusion with good success rate. Though its efficacy is documented in Western literatures and textbooks, there are no clinical trials in children has been reported from Bangladesh.
Objectives: We evaluated the efficacy of intra-pleural Streptokinase in the management of Parapneumonic effusion / complicated pleural effusion/ empyema thoracis even in advanced stages.
Patients and Methods: A total of 3 patients with parapneumonic effusion requiring intercostal tube drainage, aged 4 year 6 month to twelve years were included in the study who were admitted in Pediatric respiratory medicine unit in Dhaka Shishu (Children) Hospital. Intercostal chest tube drain was given in all patients and inj: Streptokinase (10,000 units/kg/dose) was instilled into the pleural cavity and kept the Streptokinase for 4 hour in pleural cavity. Response was assessed by clinical outcome, after unclamping and serial chest ultrasounds and subsequent chest radiography.
Results: Streptokinase enhanced drainage of pleural fluid and complete resolution of effusion in all the 3 patients.
Conclusions: Intrapleural Streptokinase is the preferred treatment for treating pediatric empyema/parapneumonic effusion/complicated pleural effusion even in advanced stages and can avoid surgery.
Bangladesh J Child Health 2020; VOL 44 (2) :104-108
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Fang, Hsin-Yueh, Ko-Wei Chang, and Yin-Kai Chao. "Ultrasound-Guided Pleural Effusion Drainage: Effect on Oxygenation, Respiratory Mechanics, and Liberation from Mechanical Ventilation in Surgical Intensive Care Unit Patients." Diagnostics 11, no. 11 (October 28, 2021): 2000. http://dx.doi.org/10.3390/diagnostics11112000.
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The question as to whether an aggressive management of post-operative pleural effusion may improve clinical outcomes after major surgery remains unanswered. The aim of this study was to investigate the effect of ultrasound-guided pleural effusion drainage on oxygenation, respiratory mechanics, and liberation from mechanical ventilation in surgical intensive care unit patients. Oxygenation and respiratory mechanics were measured before and after drainage. Over an 18-month period, a total of 62 patients were analyzed. The mean drainage volume during the first 24 h was 864 ± 493 mL, and there were no procedural complications. Both the mean PaO2/FiO2 ratio and lung compliance improved after drainage. Additionally, 41.9% (n = 26) of patients were ventilator-free within 72 h after drainage. Multivariable logistic regression analysis revealed that non-cardiovascular or thoracic surgery (odds ratio [OR] = 4.968, p = 0.046), a longer time interval from operation to the onset of pleural effusion (OR = 1.165, p = 0.005), and a higher peak airway pressure (OR = 1.303, p = 0.009) were independent adverse predictors for being free from mechanical ventilation within 72 h after drainage. Specifically, patients with a time from surgery to the onset of pleural effusion ≤6 days—but not those with an interval >6 days—showed a significant post-procedural improvement in terms of PaO2/FiO2 ratio, PaCO2, peak airway pressure, and dynamic lung compliance. In summary, ultrasound-guided pleural effusion drainage resulted in significant clinical benefits in mechanically ventilated ICU patients after major surgery—especially in those with early-onset effusion who received thoracic surgery.
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Nielsen, Per H., Søren B. Jepsen, and Agnete D. Olsen. "Postoperative Pleural Effusion Following Upper Abdominal Surgery." Chest 96, no. 5 (November 1989): 1133–35. http://dx.doi.org/10.1378/chest.96.5.1133.
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Peña Gomez Portugal, E., R. Albarran Castillo, P. Peiro Osuna, J. Benitez Beltran, E. Aguilar Neri, A. Solano Nieto, and F. Bolaños Morales. "SINGLE PORTH THORACOSCOPIC SURGERY IN PLEURAL EFFUSION." Chest 155, no. 4 (April 2019): 38A. http://dx.doi.org/10.1016/j.chest.2019.02.057.
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Üsküdar Teke, Hava, Olga Meltem Akay, Deniz Gören Şahin, Mustafa Karagülle, Eren Gündüz, and Neslihan Andıç. "Pleural Effusion: A Rare Side Effect of Nilotinib—A Case Report." Case Reports in Medicine 2014 (2014): 1–3. http://dx.doi.org/10.1155/2014/203939.
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Pleural effusion, as a side effect of tyrosine kinases, may be seen as most commonly associated with dasatinib and very rarely seen with nilotinib. In this report we present a chronic phase of CML case that was treated with nilotinib due to imatinib (Gleevec) allergy and had pleural effusion with nilotinib at 5th year of treatment. If pleural effusion develops in patients taking nilotinib and if this effusion is exudative and lymphocyte predominant, after ruling out pulmonary and cardiac etiologies, it must be associated with nilotinib; according to stage of effusion drug should be discontinued and/or steroid should be started and/or surgery should be performed.
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Devolder, K., F. Amant, P. Neven, T. Van Gorp, K. Leunen, and I. Vergote. "Role of diaphragmatic surgery in 69 patients with ovarian carcinoma." International Journal of Gynecologic Cancer 18, no. 2 (2008): 363–68. http://dx.doi.org/10.1111/j.1525-1438.2007.01006.x.
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Diaphragmatic stripping or coagulation is a technique aiming to optimally cytoreduce ovarian cancer. We investigated the complications, the overall survival, and the relapse rate following this procedure. Records of 69 patients with diaphragmatic involvement who underwent debulking surgery between September 1993 and December 2001 were reviewed. A total of 69 patients underwent diaphragmatic surgery as part of cytoreductive surgery for epithelial ovarian cancer. In 17 cases, the diaphragmatic tumors were stripped from the muscle, in 22 cases coagulated, and in 30 cases stripped and coagulated. Postoperative complications were pleural effusion (41 cases, 3 needed a chest drain, 7 needed a pleural puncture, 1 needed both) and pneumothorax (4 cases, 1 needed a chest drain). In one case of bilateral pleural effusion, the patient developed pneumonia. In one case of pleural effusion on the right side, the patient needed a pleural puncture and developed a partial atelectasis of the middle lobe of the right lung. The median overall survival was 66 months in the stripping group compared with 49 months in the coagulation group. In 56 cases (81%), the patient developed a relapse, and the first site of relapse was the diaphragm in 11 cases (20%). We conclude that diaphragmatic resection is an important part of optimal debulking surgery with an acceptable morbidity.
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Reyes, Hans A., Julie Islam, Soheila Talebi, Eder Cativo, Savi Mushiyev, Gerald Pekler, and Ferdinand Visco. "A Case of Haemorrhagic Constrictive Pericarditis with Bilateral Pleural Effusions." Case Reports in Cardiology 2016 (2016): 1–3. http://dx.doi.org/10.1155/2016/8142134.
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Presentation of pericardial disease is diverse, with the viral aetiology being the most common cause; however, when haemorrhagic pericardial effusion is present, these causes are narrowed to few aetiologies. We present a case of a young female of African descent who presented with diffuse abdominal pain and vomiting. Initial work-up showed pericardial effusion with impending echocardiographic findings of cardiac tamponade and bilateral pleural effusions. Procedures included a left video-assisted thoracoscopic surgery (VATS) with pericardial window. We consider that it is important for all physicians to be aware of not only typical presentation but also atypical and unusual clinical picture of pericardial disease.
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Chmielecki, Jan, Tomasz Kościński, and Tomasz Banasiewicz. "Pancreaticopleural Fistula as a Rare Cause of Both-Sided Pleural Effusion." Case Reports in Surgery 2021 (March 2, 2021): 1–5. http://dx.doi.org/10.1155/2021/6615612.
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A pancreaticopleural fistula is a rare cause of pleural effusion. It is a complication of chronic or acute pancreatitis. It is rarely formed to the right or both pleural cavities. Diagnosis and proper treatment often turn out to be difficult and require the cooperation of a multidisciplinary team. The authors present the case of a 59-year-old patient treated for recurrent pleural effusion of unknown origin, first to the left and then to the right pleural cavity. After many months of treatment, the diagnosis of a pancreaticopleural fistula was made. The patient underwent surgery, which finally led to a successful complete recovery. Pancreaticopleural fistula should always be considered in patients with pleural effusion of unknown origin.
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Vasudevan, Gayatri, R. Chandra, B. Vishnu Bhat, and B. D. Bhatia. "Idiopathic neonatal pleural effusion." Indian Journal of Thoracic and Cardiovascular Surgery 9, no. 1 (June 1993): 42–44. http://dx.doi.org/10.1007/bf02665337.
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Jensen, Louise, and Liyan Yang. "Risk factors for postoperative pulmonary complications in coronary artery bypass graft surgery patients." European Journal of Cardiovascular Nursing 6, no. 3 (September 2007): 241–46. http://dx.doi.org/10.1016/j.ejcnurse.2006.11.001.
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Background Despite numerous advances in anesthesia, surgical techniques, and postoperative care for coronary artery bypass graft (CABG) surgery, postoperative pulmonary complications (PPCs) still account for postoperative morbidity. Objective To determine current risk factors for PPCs in CABG surgery patients. Methods A retrospective cohort design was used. Health records were reviewed for patients ( n=315) who had CABG surgery at a large quaternary healthcare center over a 4 month period. Pre-, peri-, and postoperative risk factors for PPCs were recorded as binary variables. Data were further assessed according to PPCs and non-PPCs using logistic regression models. Results PPCs occurred in 99.4% of this CABG surgical cohort. Atelectasis, pleural effusion, atelectasis with pleural effusion, and pneumonia were the most frequent PPCs post CABG surgery. Age >65 years, diabetes, and ASA classification N3 were found to be related to the presence of atelectasis. No significant risk factors were related to the development of pleural effusion or atelectasis with pleural effusion. Postoperative pneumonia was associated with previous myocardial infarction, ventilation >10 h, and hospital stay >5 days. History of bronchitis and COPD were related to postoperative pneumothorax; history of heart failure, COPD, and other lung diseases were related to postoperative pulmonary edema. Conclusion These findings contribute to the understanding of PPCs in post-CABG surgery patients and assist in identification of patients at risk for developing PPCs.
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Kozanlı, Fatoş, and Burcu Akkök. "Contribution of immature granulocyte level to diagnosis in pleural effusion." Turkish Journal of Thoracic and Cardiovascular Surgery 30, no. 2 (April 1, 2022): 257–63. http://dx.doi.org/10.5606/tgkdc.dergisi.2022.21523.
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Background: In this study, we aimed to evaluate the diagnostic value of neutrophil and immature granulocyte levels in peripheral blood in cases with pleural effusion. Methods: Between May 2019 and May 2020, a total of 117 patients (43 males, 74 females; mean age: 63.1±18.1 years; range, 18 to 93 years) who had pleural effusion and analysis of pleural fluid were retrospectively analyzed. All patients were evaluated in terms of age, sex, presence of comorbid diseases, approach to the pleural fluid, biochemical values of peripheral blood and pleural fluid, hemogram series of peripheral blood, diagnosis of pleural fluid, and mortality. Results: Of the patients, 66 (54.5%) were diagnosed with benign pleural effusion and 51 (43.5%) were diagnosed with malignant pleural effusion. Number of cases with known primary malignancy was 54 (46.1%). Immature granulocyte count number and percentage of venous blood in the malignant pleural effusion group was significantly higher than the group with benign pleural effusion (p<0.05). Conclusion: As a hemogram parameter, immature granulocyte level is an easily applicable, cheap, and a non-invasive method in the outpatient settings.
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Alachkar, Mhd Nawar, Michael Lehrke, Nikolaus Marx, and Mohammad Almalla. "Post-cardiac injury syndrome after transcatheter mitral valve repair using MitraClip system: a case report." European Heart Journal - Case Reports 4, no. 4 (July 21, 2020): 1–5. http://dx.doi.org/10.1093/ehjcr/ytaa143.
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Abstract Background Post-cardiac injury syndrome (PCIS) is an inflammatory process that may occur after myocardial infarction, cardiac surgery, percutaneous cardiac interventions or chest trauma. To our knowledge, PCIS following transcatheter mitral valve repair (TMVr) using the MitraClip system has not been reported. Case summary A 79-year-old female with chronic heart failure and severe mitral regurgitation received TMVr using the MitraClip system. After the procedure she developed elevated inflammatory markers, pericardial and pleural effusion. Cardiac magnetic resonance provided signs of pericardial and pleural inflammation. After initiating an anti-inflammatory therapy with Aspirin and Colchicine, inflammatory markers decreased markedly, pleural and pericardial effusions were regressive, and the patient showed rapid clinical improvement. Discussion Post-cardiac injury syndrome may occur after TMVr and should be considered as a differential diagnosis in patients developing chest pain, signs of pericarditis with or without pericardial effusion and elevated inflammatory markers.
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Jain, Anant, Anusha Devarajan, Hussein Assallum, Ramin Malekan, Gregg M. Lanier, and Oleg Epelbaum. "Characteristics of early pleural effusions after orthotopic heart transplantation: comparison with coronary artery bypass graft surgery." Pleura and Peritoneum 6, no. 4 (December 1, 2021): 161–65. http://dx.doi.org/10.1515/pp-2021-0143.
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Abstract Objectives Pleural effusions appearing within the first 30 postoperative days following coronary artery bypass grafting (CABG) are classified as early and believed to be directly related to the surgery. The characteristics of such effusions are well-described. Orthotopic heart transplantation is also known to be complicated by pleural effusions; however, their characteristics have not been systematically reported. We assessed the features of early postoperative pleural effusions after heart transplantation and compared them to those of early effusions following CABG. Methods We retrospectively collected demographic, clinical, and laboratory data for patients who underwent either orthotopic heart transplantation (study group) or CABG (comparison group) at our institution and whose postoperative course within 30 days was complicated by new or worsening pleural effusion that prompted drainage. Patients subjected to analysis consisted only of those with sufficiently complete laboratory profiles to permit adequate characterization of the nature of their pleural fluid. Results Out of 251 orthotopic heart transplant recipients, seven (2.8%) were found to have sufficiently complete pleural fluid results to be included in the study group. Out of 1,506 patients who underwent CABG, 32 (2.1%) had sufficiently complete pleural fluid results and formed the comparison group. The radiological appearance of pleural effusions in both groups was similar: bilateral in at least half and exclusively moderate to large. Effusions complicating both surgeries were exudative in close to 90% of cases. For those with available leukocyte differential counts, the pleural fluid of the post-orthotopic heart transplantation group was more often neutrophilic (3/5, 60%), whereas the fluid of the post-coronary artery bypass grafting group was more often lymphocytic (22/32, 69%) and tended to be hemorrhagic (median RBC count 33,000 cells/µL vs. 10,000 cells/µL). None of the comparisons of pleural fluid characteristics between the two groups reached statistical significance. Conclusions This small, descriptive study is the first to systematically report the fluid characteristics of pleural effusions complicating orthotopic heart transplantation within the first 30 postoperative days and to compare this group to those who developed effusions after CABG. Our findings revealed both similarities and differences in the pleural fluid characteristics between these two types of patients.
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Rossolatou, Maria, Dimitris Papageorgiou, Georgia Toylia, and Georgios Vasilopoulos. "Pleural effusion in patients undergoing coronary artery bypass graft and valve replacement: a population study." Health & Research Journal 4, no. 3 (December 7, 2018): 167. http://dx.doi.org/10.12681/healthresj.19293.
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Introduction: The postoperative pleural effusion (PE) is common in patients who undergo cardiac surgery. Most of these effusions develop as a consequence of the surgical procedure itself and follow a generally benign course. The characteristics of PE and the factors predisposing factors should be documented further.Aim: The aim of this study was to determine the prevalence of PE after cardiac surgery. And also to determine whether this prevale is related to the type of cardiac surgery.Material and Methods: This retrospective study was conducted at a large private hospital in Athens. The sample of the study was all adult patients who undergo coronary artery bypass graft (CABG), valve replacement or a combination of these surgeries. A special form was made to record patients’ demographic and clinical data. Descriptive statistics and correlation studies were performed with the SPSS 22.0, at significant level a=0.05.Results: Among the 118 patients, who included in this study, 42.4% underwent CABG surgery, 29.7% valve surgery, and 28% a combination of two types of surgery. Postoperative pleural effusion was developed in 40% of those who underwent CABG, 42.9% of those who underwent cardiac valve surgery, and 42.4% of those who underwent in both types of surgeries. The mean time development of PE was 6.65 days for the CABG group, 4.8 days for the valve group and 8.7 days for the CABG +valve group. There was no statistically significant difference in the demographic and clinical data of patients with pleural effusion according the type of cardiac surgery.Conclusions: Postoperative PE is a common complication at cardiac surgery and is more common in patients undergoing surgical recuperation of valve.
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Bibby, Anna C., Selina Tsim, Nikolaos Kanellakis, Hannah Ball, Denis C. Talbot, Kevin G. Blyth, Nick A. Maskell, and Ioannis Psallidas. "Malignant pleural mesothelioma: an update on investigation, diagnosis and treatment." European Respiratory Review 25, no. 142 (November 30, 2016): 472–86. http://dx.doi.org/10.1183/16000617.0063-2016.
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Malignant pleural mesothelioma is an aggressive malignancy of the pleural surface, predominantly caused by prior asbestos exposure. There is a global epidemic of malignant pleural mesothelioma underway, and incidence rates are predicted to peak in the next few years.This article summarises the epidemiology and pathogenesis of malignant pleural mesothelioma, before describing some key factors in the patient experience and outlining common symptoms. Diagnostic approaches are reviewed, including imaging techniques and the role of various biomarkers. Treatment options are summarised, including the importance of palliative care and methods of controlling pleural effusions. The evidence for chemotherapy, radiotherapy and surgery is reviewed, both in the palliative setting and in the context of trimodality treatment. An algorithm for managing malignant pleural effusion in malignant pleural mesothelioma patients is presented. Finally new treatment developments and novel therapeutic approaches are summarised.
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Divisi, Duilio, Giovanna Imbriglio, and Roberto Crisci. "Videothoracoscopy in Pleural Empyema Following Methicillin-ResistantStaphylococcus aureus(MRSA) Lung Infection." Scientific World JOURNAL 9 (2009): 723–28. http://dx.doi.org/10.1100/tsw.2009.91.
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Our study shows the different therapeutic procedures in 64 patients with pleural effusion due to MRSA pneumonia. The thoracostomy tube associated with pleural washing was decisive in 10 simple effusion patients. Video-assisted thoracic surgery allowed a complete resolution of the disease in 22 complex parapneumonic effusion patients. In 20 of 32 patients with frank pus in the pleural cavity, the videothoracoscopic insufflation of carbon dioxide (CO2) before thoracotomy facilitated the dissection of the lung tissue. In 12 patients, this approach was not applied because of cardiac insufficiency. Videothoracoscopy and decortication after thoracotomy ensured the recovery of functions.
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Fry, Willard A., and Janardan D. Khandekar. "Parietal pleurectomy for malignant pleural effusion." Annals of Surgical Oncology 2, no. 2 (March 1995): 160–64. http://dx.doi.org/10.1007/bf02303632.
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Rajesh, Aparna, Deepa Kanagal, Harish Shetty, and Prasanna Shetty. "FIBROMA OF OVARY PRESENTING AS MEIGS' SYNDROME - A CASE REPORT." Journal of Health and Allied Sciences NU 02, no. 03 (September 2012): 24–26. http://dx.doi.org/10.1055/s-0040-1703584.
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AbstractMeigs' syndrome is a rare but well known syndrome defined as the association of ascites, pleural effusion and a benign solid ovarian tumor usually a fibroma in which tumor removal leads to complete resolution of pleural and peritoneal effusions. We report a case of Meigs' syndrome in a post menopausal woman which mimicked ovarian malignancy creating a diagnostic dilemma where the lady had complete recovery after surgery. Considering the good prognosis of Meigs' syndrome, prompt and accurate diagnosis is necessary to differentiate the syndrome from other ovarian malignancies.