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At least 235 records · Page 13Linked to original sources
PubMed1979

Acute massive hydrothorax complicating peritoneal dialysis, report of 2 cases and a review of the literature.

Acute massive right-sided hydrothorax is a relatively rare but serious complication of peritoneal dialysis and may be responsible for the development of dyspnea during peritoneal dialysis. The pleural fluid appears to arise from the peritoneal dialyzate based on the time of its appearance and its chemical composition. It should be included in the differential diagnosis when a patient becomes dyspneic during peritoneal dialysis along with exaccerbation of congestive heart failure, pneumonia, atelectasis, and purulent bronchitis. Its occurrence is an indication to stop the peritoneal dialysis and contraindicates further use of this form of dialysis. Treatment may be conservative or aggressive (thoracentesis) depending on the clinical condition of the patient. Etiology is poorly understood. In some cases, there may be traumatic diaphragmatic fenestrations, but the majority of cases appear to be due to less well defined communications between the peritoneal and pleural spaces.

Dyspnea↗
PubMed1984

[Iatrogenic hydrothorax in a premature infant and its treatment].

Iatrogenic hydrothorax in a premature infant of 36 weeks' gestation was caused by misplacement of a central venous catheter leading to massive pleural effusion in the left hemithorax. Subsequently respiratory insufficiency developed which could be treated successfully within 24 h by complete removal of the i.v. fluid via the misplaced catheter and simultaneous mechanical ventilation.

Catheterization↗
PubMed1983

Hydromediastinum and hydrothorax in the neonate with central vein catheterization.

A near fatal complication of central venous catheterization in a newborn infant is reported. Five days after insertion, the catheter tip eroded through the wall of the vein, causing hydromediastinum and hydrothorax with acute circulatory and respiratory distress. The diagnosis was confirmed by noting that the tip of the catheter had become curved downwards, by aspirating slightly bloodstained fluid from the pleural space and by injecting radio-opaque dye through the catheter. Recovery followed removal of the catheter, intercostal drainage, intubation and positive pressure respiration. The erosion of the vein may have been brought about by the location of the catheter tip at the junction of the left subclavian and innominate veins--a less than optimal position. The factors causing this complication are discussed. Recommendations are made about the type of catheter, its appropriate placement and maintenance. The diagnosis and management are surveyed.

Catheterization↗
PubMed1981

Tension hydrothorax: roentgenographic characteristics and pathogenetic consideration.

We have described a 24-year-old diabetic woman with rapidly developing left-sided tension hydrothorax. The pleural effusion was characterized by high contents of protein and glucose. The chest roentgenogram exhibited massive pleural effusion, prominent air bronchograms, mediastinal shift, and diaphragmatic inversion. Prompt thoracocentesis proved to be life-saving.

Adult↗
PubMed1981

[Hydrothorax after catheterization of the right internal jugular vein (author's transl)].

Two cases of hydrothorax are reported which developed as the result of intrapleural catheter malposition after cannulation of the right internal jugular vein. Predisposing factors for this rare, but frequently misdiagnosed, complication are discussed. In both cases control chest radiography with small doses of contrast medium as well as aspiration of blood failed to indicate malpositioning. To prevent this complication the use of larger doses of contrast medium and/or control aspiration shortly after the start of infusion are recommended.

Aged↗
PubMed1994

[Dynamics of pleural liquid in hydrothorax].

The basics of pleural liquid dynamics are summarized. The normal pleural cavity contains a small amount of pleural liquid (0.1-0.3 ml/kg). Its protein concentration is about 1.0 g/dl and its pH is 7.6. The normal flow of pleural liquid is gravity dependent, and pleural liquid flows from the costal to the mediastinal region. In experimental hydrothorax, the pleural liquid was removed mainly via lymphatics. The turnover of the pleural liquid is rapid, and it depends on the area of contact between pleural liquid and pleural and on the blood flow to the pleura.

Animals↗
PubMedDate not supplied

[Iatrogenic bilateral hydrothorax following the placement of a central catheter].

We present a case of bilateral hydrothorax after internal jugular vein catheterization. 60 hours after placing the catheter, the patient showed an abrupt picture of jugular ingurgitation, abolished vesicular breath sounds, and displaced cardiac tones. It was necessary to immediately drain one hemithorax to guarantee ventilation of the patient. The present article examines iatrogenicity derived from the placement of central catheters, and special attention is given to the need for post-insertion x-ray control.

Adult↗
PubMedDate not supplied

Intrauterine diagnosis of hydrothorax in a fetus who had a combination chylothorax and pulmonary sequestration after delivery.

Congenital hydrothorax was diagnosed prenatally by transabdominal ultrasonography. Five fetal thoracentesis procedures were performed and biochemical analyses of the fluids were done. After delivery a combination chylothorax and extralobar pulmonary sequestration was demonstrated in the infant. We believe this to be the first case report of this combination investigated prenatally. We suggest that investigators perform biochemical analyses on fetal pleural fluid removed in cases with a single diagnosis. Perhaps by comparing those data with the data reported here, a biochemical marker can be identified that will be useful in distinguishing these two conditions in utero.

Adult↗
PubMedDate not supplied

[Acute hydrothorax as a complication of peritoneal dialysis: report of a case and review of the literature].

Report a case of a patient suffering from acute pancreatitis with renal failure, who needed peritoneal dialysis and developed acute hydrothorax as a complication of the procedure. The diagnosis was made by the high levels of glucose on pleural effusion (455 mg/dL) and glycemia of 81 mg/dL). This complication probably occurs because of a pathological diaphragmatic defect, communicating peritoneal and pleural cavities. The treatment consists of prompt interruption of peritoneal dialysis with improvement of symptomatology.

Acute Disease↗
PubMed1996

[Hemilateral hydrothorax and atelectasis during laparoscopic Nissen fundoplication].

A 57-year-old woman, weighing 75 kg, with gastroesophageal sliding hernia, received laparoscopic Nissen fundoplication under general anesthesia. Although artificial ventilation was carried out uneventfully when the surgery started, sudden decreases in SpO2 and thoraco-pulmonary compliance were noted after insufflation of CO2. Breath sound was not audible on the left lung. We suspected that inadvertent pneumothorax was produced, but chest X-ray and transesophageal echocardiography at the end of surgery revealed the presence of left hemilateral hydrothorax with pulmonary atelectasis. She was ventilated artificially and given diuretics and albumin solution for 3-days before extubation. We speculated on two reasons for the event: a possibility of perforation of the diaphragm manipulated by surgeons, and that of transition of fluid used for irrigation just below the diaphragm. Pulmonary atelectasis could be induced with hemilateral lung ventilation because cephalad shifting of the diaphragm might follow the intraperitoneal insufflation. We conclude that laparoscopic surgery with insufflation of gas and irrigation with fluid requires careful attention if the laparoscopic surgery is sustained with insufflation and irrigation.

Anesthesia, General↗
PubMed1995

[Prenatal diagnosis of a hydrothorax secondary to an extralobar pulmonary sequestration].

A case of antenatal hydrothorax was observed. The aetiology could not be determined before birth. At birth an extra-lobe lung sequestation was treated surgically after 3 weeks in the intensive care unit. The surgical cure was successful with no sequellae. This favourable outcome is unusual in this type of pathology and can be explained by the fact that the sequestration was isolated in a fetus with only minimal anasarca. Indications for prenatal pleural drainage are discussed.

Adult↗
PubMed1999

[Hydrothorax caused by intravasal triple-lumen subclavian catheter].

A case in which a patient developed right-sided hydrothorax due to extravasal infusion of total parenteral nutrition (TPN) is reported. The catheter was a triluminal catheter and the tip was shown to be correctly placed in the superior vene cava by x-ray after injection of radio-opaque contrast. The most proximal injection port located 4.5 cm from the tip of the catheter was documented to be sited in the superior mediastinum outside the vena cava. The infusion was given through the proximal port of the catheter. The mechanisms underlying this complication are discussed. The case emphazises the need to control the position of all infusion ports regularly when using central venous catheters with more than one lumen.

Aged↗
PubMed2001

Radioisotope scintigraphy in the diagnosis of hepatic hydrothorax.

BACKGROUND: Pleural effusion in cirrhotic patients (hepatic hydrothorax) may result from migration of ascitic fluid across defects in the diaphragm. Biochemical analysis of ascitic and pleural fluid provides only indirect information about the nature and origin of the effusion. The present study was performed in order to demonstrate the presence/absence of peritoneo-pleural communication by radioisotope imaging. METHODS: Ten patients with cirrhotic ascites and pleural effusion were studied with 99mTc sulfur colloid scintigraphy to look for movement of the radiotracer from the peritoneal to the pleural cavity. Serum-ascitic albumin gradient (SAAG) and serum-pleural fluid albumin gradient (SPAG) values were determined in eight patients to examine the nature of the ascitic and pleural fluids. RESULTS: Transdiaphragmatic movement of ascitic fluid into the pleural space was demonstrated (generally within 2 h of intraperitoneal injection of the radiotracer) in eight of 10 patients; six on the right side, one on the left and one bilaterally. Two patients in whom pleural fluid was transudative on SPAG values were negative for peritoneo-pleural communications. CONCLUSIONS: Radionuclide scintigraphy is a simple, safe and relatively non-invasive method to confirm passage of ascitic fluid across the diaphragm.

Adult↗
PubMed1985

Right hydrothorax after left subclavian and internal jugular vein catheterization: a delayed complication.

Central vein catheterization is a common procedure performed in major hospitals. Numerous complications have been described with the use of this technique. We present three patients in whom the positioning of a catheter at the junction of the right and left brachiocephalic veins caused hydrothorax. Placing the catheter at the junction of the superior vena cava and the right atrium is recommended.

Journal Article↗
PubMed2006

[The value of thoracoscopy for diagnosis and management of refractory hepatic hydrothorax].

OBJECTIVE: To study the value of thoracoscopy for diagnosis and management of refractory hepatic hydrothorax (HH). METHODS: Twenty-six patients with refractory HH were enrolled in this study. Twenty-four of them underwent therapeutic thoracoscopy to achieve pleurodesis by application of talc poudrage. RESULTS: Nineteen of the 26 patients had dilated chest wall veins, 6 had dilated azygos veins, and 16 had diaphragm blebs. Of the 24 patients who received pleurodesis via thoracoscope, 14 cases showed complete response, and 8 showed partial response. Mild chest pain and temperature elevation were the most complaints during or after the procedure. Liver function abnormalities were the most serious side effects after pleurodesis. During the follow-up period ranging from 6 months to 3 years, 1 patient died of upper gastrointestinal hemorrhage and encephalopathy in 1 month, 3 patients died of hemorrhage in 6, 12, 18 months respectively, and 1 case experienced recurrence in 18 months. CONCLUSIONS: Defects in the diaphragm seemed to be the main cause for the development of HH. Pleurodesis achieved by thoracoscopy and talc poudrage was effective in the treatment of HH, but complications and impaired liver functions should be considered.

Adult↗