scholarly journals Explosive Pleuritis

2001 ◽  
Vol 12 (2) ◽  
pp. 104-107 ◽  
Author(s):  
Jasdeep K Sharma ◽  
Thomas J Marrie
Keyword(s):  
Computed Tomography ◽  
Pleural Effusion ◽  
Respiratory Distress ◽  
Pleural Fluid ◽  
Case Definition ◽  
Pulmonary Tissue ◽  
X Ray ◽  
Mediastinal Shift ◽  
Chest X Ray ◽  
The Right

The objective of the present paper is to describe the clinical and computed tomography features of 'explosive pleuritis', an entity first named by Braman and Donat in 1986, and to propose a case definition. A case report of a previously healthy, 45-year-old man admitted to hospital with acute onset pleuritic chest pain is presented. The patient arrived at the emergency room at 15:00 in mild respiratory distress; the initial chest x-ray revealed a small right lower lobe effusion. The subsequent clinical course in hospital was dramatic. Within 18 h of admission, he developed severe respiratory distress with oxygen desaturation to 83% on room air and dullness of the right lung field. A repeat chest x-ray, taken the morning after admission, revealed complete opacification of the right hemithorax. A computed tomography scan of the thorax demonstrated a massive pleural effusion with compression of pulmonary tissue and mediastinal shift. Pleural fluid biochemical analysis revealed the following concentrations: glucose 3.5 mmol/L, lactate dehydrogenase 1550 U/L, protein 56.98 g/L, amylase 68 U/L and white blood cell count 600 cells/mL. The pleural fluid cultures demonstrated light growth of coagulase-negative staphylococcus and viridans streptococcus, and very light growth ofCandida albicans. Cytology was negative for malignant cells. Thoracotomy was performed, which demonstrated a loculated parapneumonic effusion that required decortication. The patient responded favourably to the empirical administration of intravenous levofloxacin and ceftriaxone, and conservative surgical methods in the management of the empyema. This report also discusses the patient's rapidly progressing pleural effusion and offers a potential case definition for explosive pleuritis. Explosive pleuritis is a medical emergency defined by the rapid development of a pleural effusion involving more than 90% of the hemithorax over 24 h, which causes compression of pulmonary tissue and mediastinal shift to the contralateral side.

scholarly journals Correlation between chest x-ray findings and outcomes of patients with mechanical ventilation

2013 ◽  
Vol 53 (1) ◽  
pp. 6
Author(s):  
Indah Nurhayati ◽  
Muhammad Supriatna ◽  
Kamilah Budhi Raharjani ◽  
Eddy Sudijanto
Keyword(s):  
Mechanical Ventilation ◽  
Retrospective Study ◽  
Pleural Effusion ◽  
Respiratory Distress ◽  
Pulmonary Edema ◽  
Patient Outcomes ◽  
Morbidity And Mortality ◽  
Chi Square ◽  
X Ray ◽  
Chest X Ray

Background Most infants and children admitted to the pediatricintensive care unit (PICU) have respiratory distress and pulmonarydisease as underlying conditions. Mechanical ventilation may beused to limit morbidity and mortality in children with respiratoryfailure.Objective To assess a correlation between chest x-ray findingsand outcomes of patients with mechanical ventilation.Methods This retrospective study was held in Dr. KariadiHospital, Semarang, Indonesia. Data was collected from themedical records of children admitted to the PICU from Januaryto December 2010, who suffered from respiratory distress andused mechanical ventilation. We compared chest x-ray findings tothe outcomes of patients. Radiological expertise was provided byradiologists on duty at the time. Chi-square and logistic regressiontests were used for statistical analysis.Results There were 63 subjects in our study, consisting of 28 malesand 35 females. Patient outcomes were defined as survived or died,43 subjects ( 68%) and 20 subjects (3 2%), respectively. Chest x-rayfindings revealed the following conditions: bronchopneumonia48% (P=0.298; 95%CI 0.22 to 1.88), pleural effusion 43%(P=0.280; 95%CI 0.539 to 4.837) , pulmonary edema 6%(P=0.622; 95%CI 0.14 to 14.62) and atelectasis 3% (P=0.538;95%CI 0.03 to 7 .62). None of the chest x-ray findings significantlycorrelated to patient outcomes.Conclusion Chest x-ray findings do not correlate to patientoutcomes in pediatric subjects with mechanical ventilation inthe PICU of Dr. Kariadi Hospital, Semarang, Indonesia.

Pericardial masses and congenital abnormalities

ESC CardioMed ◽  
2018 ◽  
pp. 1582-1584
Author(s):  
Angelos G. Rigopoulos ◽  
Hubert Seggewiss
Keyword(s):  
Computed Tomography ◽  
Surgical Management ◽  
Congenital Abnormalities ◽  
Benign Lesions ◽  
Chest Computed Tomography ◽  
X Ray ◽  
Wall Calcification ◽  
Chest X Ray ◽  
Pericardial Cysts ◽  
The Right

Pericardial masses include cysts, pericardial tumours, and pericardial haematomas. Pericardial cysts are benign lesions commonly located in the right cardiophrenic angle that remain typically asymptomatic and are incidentally found in chest X-ray or chest computed tomography but might cause pressure symptoms or become infected, thus requiring surgical management. Hydatid cysts due to echinococcosis are the most common acquired pericardial cysts, characterized by wall calcification, and indicate surgery.

scholarly journals (F)utility of computed tomography of the chest in the presence of pleural effusion

2017 ◽  
Vol 2 (4) ◽  
pp. 181-186 ◽  
Author(s):  
Tilak Pathak ◽  
Malvinder S. Parmar
Keyword(s):  
Computed Tomography ◽  
Pleural Effusion ◽  
Ct Scan ◽  
Clinical Management ◽  
Chest Ct ◽  
X Ray ◽  
Contrast Enhanced ◽  
Plain Chest ◽  
Chest X Ray ◽  
Chest Ct Scan

AbstractBackgroundPleural effusion is common and can cause significant morbidity. The chest X-ray is often the initial radiological test, but additional tests may be required to reduce uncertainty and to provide additional diagnostic information. However, additional exposure and unnecessary costs should be prevented. The objective of the study was to assess the clinical benefit of an additional chest computed tomography (CT) scan over plain chest X-ray alone in the management of patients with pleural effusion.MethodsRetrospective analysis in 94 consecutive patients with pleural effusion who underwent chest X-ray and CT scan over an 18-month period in a single institution. All chest X-ray and CT scan reports were compared and correlated with clinical parameters in order to assess their utility in the clinical management. No blinding was applied.ResultsIn 75 chest CT scan reports (80 %), information provided by the radiologist did not change clinical management when compared to plain chest X-ray alone and did not provide any additional information over chest X-ray. Only 2/49 (4 %) of the native chest CT scan reports provided clinically relevant information as compared to 17/45 (38 %) contrast-enhanced chest CT scan reports (p<0.001).ConclusionsIn this retrospective cohort of patients with pleural effusion, an additional chest CT scan was not useful in the majority of patients. However, if a chest CT scan is required, then a contrast-enhanced study after pleural aspiration should be performed. Further prospective studies are required to confirm these findings.

scholarly journals Bronchial Leech Infestation in a 15-Year-Old Female

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Mohammad Ashkan Moslehi ◽  
Mohammad Hadi Imanieh ◽  
Ali Adib
Keyword(s):  
Computed Tomography ◽  
Foreign Body ◽  
Young Children ◽  
Lower Lobe ◽  
Foreign Body Aspiration ◽  
Ground Glass ◽  
Chest Computed Tomography ◽  
X Ray ◽  
Chest X Ray ◽  
The Right

Foreign body aspiration (FBA) is a common incidence in young children. Leeches are rarely reported as FBA at any age. This study describes a 15-year-old female who presented with hemoptysis, hematemesis, coughs, melena, and anemia seven months prior to admission. Chest X-ray showed a round hyperdensity in the right lower lobe. A chest computed tomography (CT) demonstrated an area of consolidation and surrounding ground glass opacities in the right lower lobe. Hematological investigations revealed anemia. Finally, bronchoscopy was performed and a 5 cm leech was found within the rightB7-8bronchus and removed by forceps and a Dormia basket.

scholarly journals Idiopathic Chylopericardium in a Young Adult: Diagnosis and Management

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
João Pedro E. Sant’Ana ◽  
Amanda O. Vicente ◽  
Amanda S. Pereira ◽  
Pedro V. Bertozzi ◽  
Rodrigo A. S. Sardenberg
Keyword(s):  
Chest Pain ◽  
Pleural Effusion ◽  
Chest Ct ◽  
Pericardial Window ◽  
X Ray ◽  
Large Pericardial Effusion ◽  
Chest X Ray ◽  
Cardiac Silhouette ◽  
The Right ◽  
Precipitating Factor

Primary idiopathic chylopericardium (PIC) is an uncommon cardiologic disorder; it is defined as accumulation of lymph in the pericardial sac without any know precipitating factor. A 25-year-old presented with dyspnea and chest pain for over two months. The patient underwent a chest X-ray, which revealed an enlargement of cardiac silhouette and signs of cardiac tamponade. Chest CT was performed, revealing large pericardial effusion and small pleural effusion on the right hemithorax. The patient was referred to the ICU and underwent a pericardial window through VATS, which revealed 500 ml of a milky fluid.

scholarly journals Metastasis of Epidermoid Cervical Carcinoma Cell to The Orbit

2018 ◽  
Vol 12 (1) ◽  
pp. 31
Author(s):  
Widiastuti Widiastuti ◽  
Rachmi Fauziah Rahayu ◽  
Djoko Susianto ◽  
Rita Budianti ◽  
Heru Priyanto ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cervical Cancer ◽  
Public Hospital ◽  
Compression Fracture ◽  
Abdominal Ultrasonography ◽  
X Ray ◽  
Metastatic Lesions ◽  
Normal Chest ◽  
Chest X Ray ◽  
The Right

Orbital metastases of cervical cancer cell are very rare. There is only one case reported in Dr. Moewardi Public Hospital Surakarta between 1999 and 2017. A 45-year-old woman was admitted with the upper right orbital lesion. She had not received a routine gynecologic examination for more than 10 years. She had normal chest X-ray. Abdominal ultrasonography revealed a heteroechoic lesion poor defined edge in cervix utery expands to corpus utery and rectum. Bilateral uropathy obstruction occured. Bone survey demonstrated osteolytic bone metastasis in the right supra orbital bone and a compression fracture of the twelfth thoracal spine. Head and orbital Computed Tomography (CT) scan, which revealed multiple metastatic lesions in the right orbital expanding to extra cranial, was performed. Our diagnosis was cervical cancer FIGO IV-B stage with distant metastasis thus chemoradiation was given. The aim of this report is to give more references regarding this complicated clinical condition.  ABSTRAKKanker serviks metastasis ke orbita sangat jarang terjadi. Hanya satu kasus yang dilaporkan di Rumah Sakit Umum Daerah Dr. Moewardi Surakarta antara tahun 1999 - 2017. Seorang wanita usia 45 tahun dirawat oleh karena lesi di orbita kanan atas sejak 2 bulan yang lalu. Pasien tersebut belum pernah mendapatkan pemeriksaan kandungan rutin selama lebih dari 10 tahun. Foto Chest X Ray normal. Ultrasonografi abdomen tampak lesi heteroekoik batas tak tegas pada serviks uterus meluas ke korpus uterus dan rektum. Terjadi obstruksi uropati kanan dan kiri. Bone survei memperlihatkan gambaran metastasis tipe litik pada tulang supra orbita kanan dan fraktur kompresi pada tulang belakang toraks ke dua belas. Computed Tomography (CT) Kepala dan Orbita memperlihatkan beberapa lesi metastasis pada supra orbita kanan yang meluas ke tulang tengkorak. Diagnosis kami adalah kanker serviks tahap FIGO IV-B dengan metastasis jauh dan diberikan therapi kemoradiasi. Tujuan penulisan ini adalah untuk memberikan lebih banyak referensi data tentang kondisi klinis yang rumit ini.

scholarly journals Case Report Mediastinal Teratoma Resembling Vascular Tumor with Rapid Growth Accompanied by Vena Cava Superior Syndrome and Bilateral Paramalignant Pleural Effusion

2020 ◽  
Vol 2 (1) ◽  
pp. 68-75
Author(s):  
Ni Rini ◽  
◽  
Suryanti Pratiwi ◽  
Imam Bayuadi ◽  
Dini Erawati ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pleural Effusion ◽  
Mediastinal Tumor ◽  
Vena Cava ◽  
Vascular Tumor ◽  
Vascular Lesions ◽  
X Ray ◽  
Mediastinal Teratoma ◽  
Vena Cava Superior ◽  
Chest X Ray

Background: Teratomas are tumors originate from germ cells, consist of well differentiated tissue from more than one of three layers of embryonic cells: ectoderm, mesoderm and endoderm. Teratomas are generally slow-growing and asymptomatic. Mediastinal teratoma is the most common extra-gonadal germ cell tumor. Superior vena cava syndrome and bilateral paramaligant pleural effusion are complications which can occur in mediastinal teratomas. Case: We report a 37-year-old woman presented with shortness of breath since 1 month before admission, chest pain, cough, weight loss, swolen of face, neck, and right arm. Chest x-ray showed mediastinal tumor. However, no mediastinal tumor had been detected by chest x-ray to examine her heart disease 3 years earlier. Chest computed tomography scan showed anterosuperior mediastinal tumor surrounding great blood vessels and bilateral pleural effusion. Computed tomography guided transthoracic fine needle aspiration biopsy revealed tumor containing mature squamous epithelial component. Patient underwent open biopsy by sternotomy and histological assessment confirmed the diagnosis as mediastinal teratoma with vascular lesions predominantly resembling vascular tumor. Conclusion: Establishing the diagnosis of mediastinal teratoma is challenging and it requires multi modality approaches.

scholarly journals A rare complication of ventriculoperitoneal shunt: Pleural effusion without intrathoracic ventriculoperitoneal shunt catheter

2020 ◽  
Vol 11 ◽  
pp. 291
Author(s):  
Said Hilmani ◽  
Tarek Mesbahi ◽  
Abderrahman Bouaggad ◽  
Abdelhakim Lakhdar
Keyword(s):  
Pleural Effusion ◽  
Ventriculoperitoneal Shunt ◽  
Rare Complication ◽  
Peritoneal Catheter ◽  
X Ray ◽  
Thoracic Drainage ◽  
Repeat Chest ◽  
Chest X Ray ◽  
The Right ◽  
Catheter Replacement

Background: Symptomatic pleural effusion following ventriculoperitoneal shunt (VPS) insertion is very rare and poorly understood in the literature in contrary to other mechanical complications. Case Description: We report a case of 15 month-year-old girl who had VP shunt for congenital hydrocephalus. Twelve months after surgery, she was diagnosed with massive hydrothorax. Chest X-ray and thoracoabdominal CT scan confirmed the right pleurisy and showed the tip of the peritoneal catheter in the general peritoneal cavity. We made thoracic drainage of the transudative pleural effusion. When we released the chest tube, 24 h after, the girl showed a respiratory distress again and the effusion resumed at the X-ray control. Her symptoms abated after the realization of a ventriculoatrial shunt “VAS.” Repeat chest X-ray confirmed the resolution of the hydrothorax. Conclusion: Despite the not yet well-understood mechanism of this rare and important VPS complication, management is simple based on X-ray confirmation, thoracentesis with biological analysis, and catheter replacement, especially in atrium “VAS.”

scholarly journals Management of Pleural Brucellosis: Case Report

2009 ◽  
Vol 2 ◽  
pp. IDRT.S2235 ◽  
Author(s):  
Adel Alothman ◽  
Salih Bin Salih ◽  
Salwa Alothman ◽  
Ghassan Al Johani
Keyword(s):  
Case Report ◽  
Pleural Effusion ◽  
Incidence Rate ◽  
Pleural Fluid ◽  
Middle Eastern ◽  
Developed Countries ◽  
History Of ◽  
Chest X Ray ◽  
Low Incidence ◽  
The Right

Background Brucellosis is a zoonotic disease, with low incidence rate in developed countries, however the incidence rate in Middle Eastern countries remains high. Chest symptoms in brucellosis cases account for about 15% of the cases, but dealing with respiratory system involvement is rare particularly pleural involvement. Case Report We report a case of a 60-year-old Saudi woman who was admitted with two months history of fever, productive cough anorexia and weight loss, contact with sheep. She was ill looking, underweight and febrile while she was on treatment. Examination of the chest showed signs of pleural effusion on the right side with right infrascapular crepitations. Chest X-ray: showed pleural effusion and right LL infiltrates. CT chest: showed right loculated, pleural effusion. Pleural fluid examination showed exudative changes, on culture of pleural fluid, Brucella species grew. AFB in pleural fluid was negative. She was treated with Streptomycin, Doxycyclin and Ciprofloxacin. She improved within one week of treatment and was discharged, after 14 days on antibrucella therapy. Discussion Pulmonary brucellosis is reported in medical literature occasionally but only few reports are available about pleural brucellosis. The challenge with pleural brucellosis and the association of loculated abscesses lies in therapy. Due to lack of previous information with such cases, we suggest that a period of more than six weeks is needed to treat this condition. We recommend that pleural brucellosis needs to be treated with at least two therapeutic agents for nine weeks.

scholarly journals Tension hydrothorax in a patient with SARS-CoV-2 pneumonitis and pleural Mycobacterium tuberculosis

2021 ◽  
Vol 14 (7) ◽  
pp. e243760
Author(s):  
Mohsin F Butt ◽  
Maggie Symonds ◽  
Ruhaid Khurram
Keyword(s):  
Emergency Department ◽  
Mycobacterium Tuberculosis ◽  
Pleural Effusion ◽  
Respiratory Distress ◽  
Chest Radiograph ◽  
Left Lung ◽  
Pleural Effusions ◽  
Mediastinal Shift ◽  
History Of ◽  
The Right

Unilateral pleural effusions are uncommonly reported in patients with SARS-CoV-2 pneumonitis. Herein, we report a case of a 42-year-old woman who presented to hospital with worsening dyspnoea on a background of a 2-week history of typical SARS-CoV-2 symptoms. On admission to the emergency department, the patient was severely hypoxic and hypotensive. A chest radiograph demonstrated a large left-sided pleural effusion with associated contralateral mediastinal shift (tension hydrothorax) and typical SARS-CoV-2 changes within the right lung. She was treated with thoracocentesis in which 2 L of serosanguinous, lymphocyte-rich fluid was drained from the left lung pleura. Following incubation, the pleural aspirate sample tested positive for Mycobacterium tuberculosis. This case demonstrates the need to exclude non-SARS-CoV-2-related causes of pleural effusions, particularly when patients present in an atypical manner, that is, with tension hydrothorax. Given the non-specific symptomatology of SARS-CoV-2 pneumonitis, this case illustrates the importance of excluding other causes of respiratory distress.

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