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Pleural Effusion
A pleural effusion is accumulation of excessive fluid in the pleural space, the potential space that surrounds each lung. Under normal conditions, pleural fluid is secreted by the parietal pleural capillaries at a rate of 0.6 millilitre per kilogram weight per hour, and is cleared by lymphatic absorption leaving behind only 5–15 millilitres of fluid, which helps to maintain a functional vacuum between the parietal and visceral pleurae. Excess fluid within the pleural space can impair inhalation, inspiration by upsetting the functional vacuum and hydrostatically increasing the resistance against lung expansion, resulting in a fully or partially collapsed lung. Various kinds of fluid can accumulate in the pleural space, such as serous fluid (hydrothorax), blood (hemothorax), pus (pyothorax, more commonly known as pleural empyema), chyle (chylothorax), or very rarely urine (urinothorax) or feces (coprothorax). When unspecified, the term "pleural effusion" normally refers to hydro ...
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Pulmonology
Pulmonology (, , from Latin ''pulmō, -ōnis'' "lung" and the Greek suffix "study of"), pneumology (, built on Greek πνεύμων "lung") or pneumonology () is a medical specialty that deals with diseases involving the respiratory tract.ACP: Pulmonology: Internal Medicine Subspecialty
. Acponline.org. Retrieved on 2011-09-30.
It is also known as respirology, respiratory medicine, or chest medicine in some countries and areas. Pulmonology is considered a branch of internal medicine, and is related to intensive care medicine. Pulmonology often ...
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Pleural Empyema
Pleural empyema is a collection of pus in the pleural cavity. It is caused by microorganisms, usually bacteria. It often happens in the context of a pneumonia, injury, or chest surgery. It is one of the various kinds of pleural effusion. Pleural empyema contain three stages: exudative: when there is an increase in pleural fluid with or without the presence of pus; fibrinopurulent: when fibrous septa form localized pus pockets, and the final organizing stage: when there is scarring of the pleura membranes with possible inability of the lung to expand. Simple pleural effusions occur in up to 40% of bacterial pneumonias. They are usually small and resolve with appropriate antibiotic therapy. However, if an empyema develops additional intervention is required. Signs and symptoms The clinical presentation of both the adult and pediatric patient with pleural empyema depends upon several factors, including the causative micro-organism. Most cases present themselves in the setting of a ...
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Empyema
An empyema (; ) is a collection or gathering of pus within a naturally existing anatomical cavity. The term is most commonly used to refer to pleural empyema, which is empyema of the pleural cavity. It is similar or the same in meaning as an abscess, but the context of use may sometimes be different. For instance, appendicular abscess is also formed within a natural cavity as the definition of empyema. Empyema most commonly occurs as a complication of pneumonia but can also result from other infections or conditions that lead to the collection of infected fluid in a body cavity. Classification Empyema occurs in: * the pleural cavity ( pleural empyema also known as pyothorax) * the thoracic cavity * the uterus ( pyometra) * the appendix (appendicitis) * the meninges ( subdural empyema) * the joints (septic arthritis) * the gallbladder Diagnosis Chest X-rays or computed tomography (CT) scans can reveal the presence of fluid within the pleural space and help assess its ...
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Chyle
Chyle (; ) is a milky bodily fluid consisting of lymph and emulsified fats, or free fatty acids (FFAs). It is formed in the small intestine during digestion of fatty foods, and taken up by lymph vessels specifically known as lacteals. The lipids in the chyle are colloidally suspended in chylomicrons. Clinical significance A chyle fistula occurs when defect(s) of lymphatic vessel(s) result in leakage of lymphatic fluid, typically accumulating in the thoracic (pleural) or abdominal (peritoneal) cavities, leading to a chylous pleural effusion ( chylothorax) or chylous ascites, respectively. Diagnosis of a chyle fistula may be accomplished by analysis of pleural/peritoneal fluid. Identifying the source (localizing the lymphatic defect) is often challenging, but may be accomplished with lymphangiography, which is occasionally associated with a serendipitous therapeutic effect (resolution of the leak), thought to be secondary to a sclerosant effect of the lymphangiography contras ...
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Haemothorax
A hemothorax (derived from hemo- lood+ thorax hest plural ''hemothoraces'') is an accumulation of blood within the pleural cavity. The symptoms of a hemothorax may include chest pain and difficulty breathing, while the clinical signs may include reduced breath sounds on the affected side and a rapid heart rate. Hemothoraces are usually caused by an injury, but they may occur spontaneously due to cancer invading the pleural cavity, as a result of a blood clotting disorder, as an unusual manifestation of endometriosis, in response to pneumothorax, or rarely in association with other conditions. Hemothoraces are usually diagnosed using a chest X-ray, but they can be identified using other forms of imaging including ultrasound, a CT scan, or an MRI. They can be differentiated from other forms of fluid within the pleural cavity by analysing a sample of the fluid, and are defined as having a hematocrit of greater than 50% that of the person's blood. Hemothoraces may be treated b ...
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Blood
Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood is composed of blood cells suspended in blood plasma. Plasma, which constitutes 55% of blood fluid, is mostly water (92% by volume), and contains proteins, glucose, mineral ions, and hormones. The blood cells are mainly red blood cells (erythrocytes), white blood cells (leukocytes), and (in mammals) platelets (thrombocytes). The most abundant cells are red blood cells. These contain hemoglobin, which facilitates oxygen transport by reversibly binding to it, increasing its solubility. Jawed vertebrates have an adaptive immune system, based largely on white blood cells. White blood cells help to resist infections and parasites. Platelets are important in the clotting of blood. Blood is circulated around the body through blood vessels by the ...
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Serous Fluid
In physiology, serous fluid or serosal fluid (originating from the Medieval Latin word ''serosus'', from Latin ''serum'') is any of various body fluids resembling serum, that are typically pale yellow or transparent and of a benign nature. The fluid fills the inside of body cavities. Serous fluid originates from serous glands, with secretions enriched with proteins and water. Serous fluid may also originate from mixed glands, which contain both mucous and serous cells. A common trait of serous fluids is their role in assisting digestion, excretion, and respiration. In medical fields, especially cytopathology, serous fluid is a synonym for effusion fluids from various body cavities. Examples of effusion fluid are pleural effusion and pericardial effusion. There are many causes of effusions which include involvement of the cavity by cancer. Cancer in a serous cavity is called a serous carcinoma. Cytopathology evaluation is recommended to evaluate the causes of effusions in these ...
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Hydropneumothorax
Hydropneumothorax is defined as the presence of both air and fluid within the pleural space. An upright chest x-ray will show air fluid levels. The horizontal fluid level is usually well defined and extends across the whole length of one of the hemithorax. Signs and symptoms This can be remembered by the 4 'S': straight line dullness, shifting dullness, splash, sound of coin. Causes * Iatrogenic: Introduction of air during pleural fluid aspiration in effusion * Presence of a gas-forming organism * Thoracic trauma Diagnosis Diagnosis can be via CXR. CT is better for outlining borders of air-fluid levels, however, CT has a greater radiation exposure. Ultrasound imaging Medical ultrasound includes diagnostic techniques (mainly imaging) using ultrasound, as well as therapeutic applications of ultrasound. In diagnosis, it is used to create an image of internal body structures such as tendons, muscles, join ... has also proven to be a useful tool for hydropneumothor ...
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Pneumothorax
A pneumothorax is collection of air in the pleural space between the lung and the chest wall. Symptoms typically include sudden onset of sharp, one-sided chest pain and dyspnea, shortness of breath. In a minority of cases, a one-way valve is formed by an area of damaged Tissue (biology), tissue, and the amount of air in the space between chest wall and lungs increases; this is called a tension pneumothorax. This can cause a steadily worsening Hypoxia (medical), oxygen shortage and hypotension, low blood pressure. This leads to a type of shock called obstructive shock, which can be fatal unless reversed. Very rarely, both lungs may be affected by a pneumothorax. It is often called a "collapsed lung", although that term may also refer to atelectasis. A primary spontaneous pneumothorax is one that occurs without an apparent cause and in the absence of significant lung disease. A secondary spontaneous pneumothorax occurs in the presence of existing lung disease. Smoking increases ...
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Feces
Feces (also known as faeces American and British English spelling differences#ae and oe, or fæces; : faex) are the solid or semi-solid remains of food that was not digested in the small intestine, and has been broken down by bacteria in the large intestine. Feces contain a relatively small amount of metabolic waste products such as bacterially-altered bilirubin and dead epithelial cells from the lining of the gut. Feces are discharged through the anus or cloaca during defecation. Feces can be used as fertilizer or soil conditioner in agriculture. They can also be burned as dry animal dung fuel, fuel or dried and used for wattle and daub, construction. Some medicinal uses have been found. In the case of human feces, fecal transplants or fecal bacteriotherapy are in use. Urine and feces together are called excretion, excreta. Characteristics The distinctive odor of feces is due to skatole, and thiols (sulfur-containing compounds), as well as amines and carboxylic acids. Sk ...
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Urinothorax
Urinothorax (''pl''. urinothoraces) is defined as urine in the Pleural cavity, fluid-filled cavity that surrounds the lungs. It is usually caused by obstructive uropathy. It is mainly diagnosed by analyzing the pleural fluid. Treatment involves treating the underlying condition, which typically results in resolution of the urinothorax. It is an extremely rare cause of pleural effusion. Signs and symptoms The characteristics of people affected by urinothorax are poorly defined. Urology, Urological symptoms tend to occur, while the Respiratory disease, respiratory symptoms are typically nonexistent or mild. Difficulty breathing, occurring in moderate to large pleural effusions, is the most common respiratory symptom. Other symptoms include fever, abdominal pain, chest pain, and reduced urination. It typically occurs within hours of the causative condition. Causes Urinothorax is usually caused by obstructive uropathy. The obstructive uropathy may be at the urinary bladder or ur ...
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