Although a hydropneumothorax is not frequently mentioned in the medical literature [1], its non-specific clinical appearance has been attributed to several conditions. Tumors, such as malignant pleural mesotheliomas (MPMs) and angiosarcomas, are documented as potential causes, whereas tuberculosis is designated as the most common infectious etiology of a hydropneumothorax, but hydatid lung disease caused by echinococcus granulosus is also reported as a possible cause [1] [2] [3] [4]. On the other hand, invasive procedures of the lungs - thoracocentesis, placement of chest tubes and even a transbronchial biopsy all carry a risk for a post-procedural hydropneumothorax, suggesting their important role in the pathogenesis of this condition [5]. The clinical presentation starts with an acute onset of respiratory insufficiency characterized by dyspnea, breathlessness and an overall decline in respiratory function, whereas additional signs of fever and constitutional symptoms (weight loss, malaise, anorexia) are often seen if tuberculosis is the underlying cause [1]. Chest pain aggravated by deep breathing and a cough is reported in patients who suffer from hydatid disease, in whom cystic penetration into the pleural space causes hydropneumothorax [4]. In a small number of cases, an urticarial reaction and even anaphylaxis can occur once immune cells interact with the echinococcal cysts [4].

• Hypoxemia

  Hypoxemia was present in 35 patients (61.4%). All patients had exudative effusion. Etiological diagnosis was possible in 35 patients by initial work-up and 22 required CT thorax for arriving at a diagnosis. [ncbi.nlm.nih.gov]

• Asymptomatic

  Introduction Pulmonary involvement in endometriosis is well described in the literature but asymptomatic significant hydropneumothorax is considered an unusual presentation 1. [onlinelibrary.wiley.com]

  Pulmonary manifestations in sarcoidosis vary, ranging from asymptomatic chest radiographic abnormalities to progressive destruction of lung parenchyma with respiratory insufficiency. [ncbi.nlm.nih.gov]

  All had pneumothoraces that occupied at least 30% of the hemithorax; all were asymptomatic; all had underlying parenchymal disease and noncompliant lungs. Pleural effusion reaccumulated in all 17 after removal of the chest tube. [ajronline.org]

  Large asymptomatic hydropneumothorax after thora-centesis. J Vasc Interv Radiol. 2004; 15:1047-9. Caceres M, Ali SZ, Braud R, Weiman D, Garrett HE Jr. Spontaneous pneumomediastinum: a comparative study and review of the literature. [jctm.mums.ac.ir]

• Anemia

  The middle cerebral artery Doppler known as MCA peak systolic velocity is a good noninvasive measure of fetal anemia. With fetal anemia and possible hypoxia, velocity of blood flow to the fetal brain increases. [intechopen.com]

  Natural History •50%of affected infants have mild anemia, requiring either phototherapy or no treatment. •25%have hepatosplenomegaly, moderate anemia and progressive jundice ending in kernicterus, neonatal death •25%are hydropic and die in utero or in [slideshare.net]

  This causes anemia. Hydrops can occur if the developing baby's organs can't overcome the anemia. The heart starts to fail. Large amounts of fluid build up in the baby's tissues and organs. [stanfordchildrens.org]

  […] the recipient twin twin reversed arterial perfusion sequence: in pump twin in utero infection(s) congenital viral infection(s) TORCH group fetal parvovirus B19 infection: considered the most common infectious cause of hydrops; the mechanism is that of anemia [radiopaedia.org]

  5.8% of meconium peritonitis, 5.1% of thoracic-lung disease, 4.5% of chromosomal abnormalities, and 1.9% of immune anemia. [12] Alpha thalassemia was the most common nonimmune anemia (96%). [emedicine.medscape.com]

• Congestive Heart Failure

  heart failure Pneumochylothorax Pseudochylothorax Tension hydrothorax Applies To Encysted pleurisy Hemopneumothorax Hemothorax Hydropneumothorax Hydrothorax ICD-9-CM Volume 2 Index entries containing back-references to 511.89 : [icd9data.com]

  Differential diagnosis The many disorders associated with HF are differential diagnoses such as neonatal hemochromatosis, twin-to-twin transfusion syndrome, congestive heart failure, hepatitis B, hypercalcemia, hypernatremia, hypothrombinemia, hypothyroidism [orpha.net]

  heart failure Cardiac failure Cardiac failures Heart failure [ more ] 0001635 Nonimmune hydrops fetalis 0001790 Showing of 4 | Last updated: 1/1/2020 If you need medical advice, you can look for doctors or other healthcare professionals who have experience [rarediseases.info.nih.gov]

  Examples of transudate pleural effusions include:     congestive heart failure, liver failure or cirrhosis, kidney failure or nephritic syndrome, and peritoneal dialysis. 2. [docshare.tips]

• Pallor

  No pallor, clubbing, and peripheral edema were apparent. Chest ultrasonography showed large, hypoechoic, right-sided pleural effusion, with a flattened diaphragm and paradoxical diaphragmatic motion. [thoracickey.com]

  Mild forms may cause: Liver swelling Change in skin color (pallor) More severe forms may cause: Breathing problems Bruising or purplish bruise-like spots on the skin Heart failure Severe anemia Severe jaundice Total body swelling An ultrasound done during [medlineplus.gov]

  Pallor and proptosis were observed. Chest examination revealed bulging right anterior hemithorax with diminished movement. Subcutaneous crepitus was palpated over the swollen area. Both the trachea and cardiac apex were shifted to the left side. [atmph.org]

• Pleural Effusion

  The ultrasound displays rhythmic alternation between showing a pneumothorax and showing a pleural effusion. [emcrit.org]

  Pleural effusion will reaccumulate in the residual space over a variable period of time. [ajronline.org]

  Arrow, boundary between pneumothorax and pleural effusion; star, anechoic pleural effusion; arrowheads, pneumothorax chamber. [thoracickey.com]

  Most cases with tension pneumothorax showed pleural effusion appearing simultaneously in the same side. [onlinelibrary.wiley.com]

• Sputum

  Sputum culture showing gram- negative rods Serratia marcescens and positive acid-fast bacilli for mycobacterium tuberculosis, pleural fluid is strongly exudative and sputum AFB smear showed positive PCR for Mycobacterium tuberculosis complex. [pesquisa.bvsalud.org]

  Bronchoscopy may be useful if multiple sputum examinations are negative in diagnosing pulmonary nocardiosis. [ncbi.nlm.nih.gov]

  Sputum acid-fast bacilli staining (AFB) was positive for mycobacterium tuberculosis. [emedicalacademy.com]

  Pleural fluid and sputum culture revealed significant growth of A. fumigatus. Sputum was negative for other pyogenic organisms and acid-fast bacilli. Sputum for GeneXpert MTB was also negative. [ijrconline.org]

• Dyspnea

  CASE REPORT: A 97-year-old woman complained of acute dyspnea without prior vomiting. Chest x-ray study showed a large right pneumothorax with associated effusion. [read.qxmd.com]

  It is typically diagnosed after patients present with nonspecific symptoms of chest pain, dyspnea, and cough with initial imaging most commonly showing unilateral pleural effusion. [ncbi.nlm.nih.gov]

  Case contributed by Dr Aditya Shetty Diagnosis certain Diagnosis certain Presentation h/o dyspnea Patient Data Age: 30 Gender: Male From the case: Hydropneumothorax X-ray Frontal A large radiolucent area noted in the left upper and mid zone with a sharply [radiopaedia.org]

  Abstract A 61-year-old man was admitted to the emergency room because of sudden right chest pain and dyspnea. A chest X-ray and chest computed tomography (CT) revealed severe right pneumothorax with massive pleural effusion. [jtd.amegroups.com]

  The clinical presentation starts with an acute onset of respiratory insufficiency characterized by dyspnea, breathlessness and an overall decline in respiratory function, whereas additional signs of fever and constitutional symptoms (weight loss, malaise [symptoma.com]

• Malignant Pleural Effusion

  We reviewed the charts of these 17 patients to document the cause of malignant pleural effusion, presence of underlying malignant parenchymal disease, volume of fluid aspirated, and improvement in symptoms. [ajronline.org]

  The efficacy of doxycycline as a pleural sclerosing agent in malignant pleural effusion: a prospective study. Respirology 1996;l:69-72. ‎ [books.google.de]

  /B978-0-323-79541-8.00001-1 State Published - Jan 1 2021 Hydropneumothorax Indwelling pleural catheters Malignant pleural effusion Nonexpandable lung Pleural manometry Thoracentesis Thoracoscopy Medicine(all) APA Standard Harvard Vancouver Author BIBTEX [jhu.pure.elsevier.com]

• Hypertension

  Juan Olazagasti Patient History year-old female with a history of moderate COPD, stage IB lung cancer, hypertension, and anxiety after lobectomy Images Discussion Osteophytes seen on lateral view within the vertebral column. [chestcases.med.virginia.edu]

  A 73-year-old male with a past medical history of chronic right pleural effusion, restrictive ventilatory impairment and hypertension presented to us for evaluation of severe right chest pain of few days’ duration and severe dyspnoea. [birpublications.org]

  […] pneumonia viêm phổi thùy lung abscess abscess phổi obstructive lung diseases bệnh phổi tắc nghẽn pleural effusion tràn dịch màng phổi pleuritis viêm màng phổi pneumoconioses bệnh bụi phổi pneumothorax tràn khí màng phổi pulmonary edema phù phổi pulmonary hypertension [memrise.com]

  Eight patients (14.0%) had hypotension at presentation, four patients (7%) were hypertensive, and rest 45 (78.9%) had normal blood pressure. [journals.lww.com]

  She reported a history of iron deficiency anemia, endometriosis, and hypertension. She had received an injection of depot-medroxyprogesterone acetate approximately one week prior to presentation. [shmabstracts.org]

• Heart Disease

  His past medical history was significant, with hypertension and ischemic heart disease. Pre-operative CXR ( Fig. 2 ) showed a small right hydropneumothorax and a chest drain in place. No chest CT-scan was performed. [journalpulmonology.org]

  Patients were also enquired regarding presence of comorbidities such as diabetes mellitus, hypertension, ischemic heart disease, and history of tuberculosis (TB) and immunocompromised state. Detailed clinical examination was done. [journals.lww.com]

• Hydrops Fetalis

  Types of hydrops fetalis There are two kinds of hydrops fetalis: immune and non-immune. The type depends on the cause of the condition. Non-immune hydrops fetalis Non-immune hydrops fetalis is now the most common type of hydrops fetalis. [healthline.com]

  Home Diseases Hydrops fetalis Title Other Names: Idiopathic hydrops fetalis; Hydrops fetalis nonimmune; Familial non-immune hydrops fetalis Hydrops fetalis is a serious condition in which abnormal amounts of fluid build up in two or more body areas of [rarediseases.info.nih.gov]

  There are two types of hydrop fetalis:Immune hydrops fetalis (IHF). Non-immune hydrops fetalis (NIHF). We report a case of NIHF delivered by a 18 year old primi gravida. [semanticscholar.org]

• Agitation

  In the ICU, he was severely agitated; however, he was able to endorse experiencing multiple episodes of hematemesis over 4 hours on the day before presentation. [journal.chestnet.org]

  However, his clinical status worsened rapidly: his SpO 2 decreased to 80% with 6 L/min of oxygen via nasal cannula, his blood pressure was 80/50 mmHg, and he was agitated. [onlinelibrary.wiley.com]

Although a hydropneumothorax is principally diagnosed through imaging studies, physicians can include it in the differential diagnosis of respiratory symptoms only after a thorough patient history and a physical examination focused on lung auscultation. Tachypnea, signs of cyanosis and an "inconclusive" lung sound heard at the level of hydropneumothorax formation should prompt the physician to order a plain chest X-ray, a procedure that will undoubtedly reveal an air-fluid level lined almost perfectly at a horizontal level, mimicking pleural effusion [6]. Furthermore, signs of lung collapse and pleural effusion may be shown on plain radiography and computed tomography (CT), which is also recommended during workup, especially if radiography is not conclusive [6]. However, transthoracic sonography (TS) has shown to be an equally useful method in detecting pleural pathologies [7]. In fact, its cost-effectiveness and the ability to perform the procedure bed-side, favor its use over plain radiography, especially when only supine X-rays can be carried out due to the overall condition of the patient [7].

• Atelectasis

  Download figure Open in new tab Download powerpoint Figure 3 CT scan—right pleura extensively thickened and calcified, with a hydropneunmothorax, possibly corresponding to empyema, in the right lower hemithorax and increased lung opacity and atelectasis [casereports.bmj.com]

  This showed voluminous bullae and cystic lesions in the left hemithorax of up to 20 cm in diameter, with atelectasis of the pulmonary parenchyma, patent bronchi and air-fluid level in the left pleural space, and left anterior and basal pneumothorax; the [archbronconeumol.org]

  We report a rare case of rounded atelectasis with pneumothorax that persisted over a prolonged period. [ci.nii.ac.jp]

• Pleural Effusion

  The ultrasound displays rhythmic alternation between showing a pneumothorax and showing a pleural effusion. [emcrit.org]

  Pleural effusion will reaccumulate in the residual space over a variable period of time. [ajronline.org]

  Arrow, boundary between pneumothorax and pleural effusion; star, anechoic pleural effusion; arrowheads, pneumothorax chamber. [thoracickey.com]

  Most cases with tension pneumothorax showed pleural effusion appearing simultaneously in the same side. [onlinelibrary.wiley.com]

Apart from this, antitubercular drugs for the treatment of tuberculosis and antibiotics for the treatment of bacterial etiology should be given. [ijrc.in]

Treatment depends on the location and the extent of the perforation as surgical intervention is the gold standard. [swjpcc.com]

He completed 12 days of IV antibiotic treatment and required a chest tube for drainage. Patient was discharged home with a full recovery. 1. [hindawi.com]

Treatment[edit] Treatment includes ICD (intercostal drainage) of fluid and air and treatment of underlying conditions. References[edit] ^ Clarke, Christopher; Dux, Anthony (2017). Chest X-rays for Medical Students. John Wiley & Sons. p. 82. [en.wikipedia.org]

INTRODUCTION Angiosarcoma is a rare aggressive malignancy that has a poor prognosis despite current intensive treatment [1-3]. This tumor can involve multiple organs, including the pleura. [openrespiratorymedicinejournal.com]

The overall prognosis can be variable, dependent on the underlying cause. [radiopaedia.org]

While the prognosis for IPA remains poor, early initiation of antifungals has been shown to improve outcomes. [amjcaserep.com]

Etiologic diagnosis will guide prognosis and the selection of specific chemotherapy. [ncbi.nlm.nih.gov]

Prognosis In most cases, prognosis is poor with a perinatal mortality rate ranging from 55-98%, but it is dependent on etiology. The documents contained in this web site are presented for information purposes only. [orpha.net]

Extensive pleural fluid analysis is essential in establishing etiological diagnosis. TB is the most common etiology. ICD for long duration with antimicrobial chemotherapy is the management. [lungindia.com]

Knowledge of the epidemiology and clinical characteristics of maternal and fetal infection can be used to select a diagnostic approach. Etiologic diagnosis will guide prognosis and the selection of specific chemotherapy. [ncbi.nlm.nih.gov]

Medical Chemistry and Biochemistry (317) Genetics (221) Surgery, Traumatology and Orthopaedics (204) Psychiatry, Psychology, Sexology (177) Infectology (136) Cardiology, Angiology (130) Gastroenterology and Hepatology (117) Endocrinology, Metabolism (108) Epidemiology [portal.mefanet.cz]

Summary Epidemiology The prevalence of NIHF is unknown as it is difficult to obtain when many cases are not diagnosed before intrauterine death or may spontaneously resolve antenatally. Currently, NIHF constitutes up to 90% of all HF cases. [orpha.net]

Baddley JW, Stephens JM, Ji X, Aspergillosis in Intensive Care Unit (ICU) patients: Epidemiology and economic outcomes: BMC Infect Dis, 2013; 13; 29 10.. [amjcaserep.com]

Pathophysiology, investigations, treatment and counseling are outlined. [intechopen.com]

The pathophysiology of pneumothorax ex-vacuo remains unclear. Several potential hypotheses have been proposed. [bmcpulmmed.biomedcentral.com]

Internal Medicine (467) Paediatrics, Neonatology (455) Physiology and Pathophysiology (422) Pathology and Forensic Medicine (365) Neurology (323) Medical Chemistry and Biochemistry (317) Genetics (221) Surgery, Traumatology and Orthopaedics (204) Psychiatry [portal.mefanet.cz]

Osborn waves in myocardial ischemia in absence of hypothermia have been very well described as an early manifestation of left circumflex (LCx) artery infarction.[4] Pathophysiologically, the heterogeneous distribution of a transient outward current-mediated [ijciis.org]

Early removal of fixation wires and regular follow-up if wires are retained are essential to prevent serious complications. [ncbi.nlm.nih.gov]

Nasogastric intubation is associated with iatrogenic complications in up to 8% of the cases.1 The most common ones are related to the respiratory system.2 In order to prevent such accidents, the use of auxiliary techniques such as the capnography and [casereports.bmj.com]

1. Kasargod V, Awad NT. Clinical profile, etiology, and management of hydropneumothorax: An Indian experience. Lung India. 2016;33(3):278-280.
2. Fayed HE, Woodcock VK, Grayez J. Simultaneous bilateral spontaneous hydropneumothorax: a rare presentation of bilateral malignant pleural mesothelioma. BMJ Case Rep. 2013;2013:bcr2013009350.
3. Chang JH, Kim JH, Hong S-H, et al. Angiosarcoma Presenting with Spontaneous Hydropneumothorax: Report of a Case and Review of the Literature. Open Respir Med J. 2014;8:48-54.
4. Zefov VN, Almatrooshi MA. Chest X-ray findings in late-onset congenital diaphragmatic hernia, a rare emergency easily misdiagnosed as hydropneumothorax: a case report. Journal of Medical Case Reports. 2015;9:291.
5. Boland GW, Gazelle GS, Girard MJ, Mueller PR. Asymptomatic hydropneumothorax after therapeutic thoracentesis for malignant pleural effusions. AJR Am J Roentgenol. 1998;170(4):943-946.
6. Atay AE, Oruc M, Sayin T, Gullu MN. Urticaria and hydropneumothorax as an exceptional cause of ruptured hydatid cyst of lung. J Postgrad Med. 2013;59(4):328-330.
7. Reissig A, Kroegel C. Accuracy of transthoracic sonography in excluding post-interventional pneumothorax and hydropneumothorax. Comparison to chest radiography. Eur J Radiol. 2005;53(3):463-470.