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Pleural Adhesions


Presentation

  • Such adhesion will not occur so long as fibrine is present on the surface, and is to be carefully distinguished from the mere glueing which may occur in the earlier stages from the adhesion of the fibrinous exudation on opposed surfaces.[chestofbooks.com]
  • The delay in timing of the second stage of the procedure depends on the individual case, but complications from foreign body reaction were not seen up to 30 days after Silon insertion in one of the cases presented.[healio.com]
  • Tissues present include: Pleura, adipose tissue, skeletal muscle, nerves and lung parenchyma.[histopathology-india.net]
  • Pleural TB was present in 31 cases (24%) on histopathology. Only 3 patients had AFB positivity on pleural biopsy.[lungindia.com]
  • Six consecutive patients with tuberculous pleural effusions are here presented. Diagnosis was established with the aid of tuberculin test, cultures of gastric washings and pleural fluid, and pleural biopsy.[pediatrics.aappublications.org]
Pleuritic Pain
  • Pleuritic pain can usually be managed with NSAIDs or other oral analgesics. At times, a short course of oral opioids is required.[merckmanuals.com]
Pleural Disorder
  • Egypt J Bronchol 2015;9:92-5 Introduction Medical thoracoscopy is now an established technique for diagnosis and management of various pleural disorders [1].[ejbronchology.eg.net]
Acute Abdomen
  • abdomen and new material on CT and MR angiography, lung cancer screening, pulmonary embolism, coronary artery calcium screening, and interventional CT techniques including radiofrequency ablation and CT fluoroscopy.[books.google.com]
Hematochezia
  • Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis Case 4-2019: An 18-Year-Old Man with Abdominal Pain and Hematochezia Bridging the Gap Challenge Yourself[nejm.org]
Chest Pain
  • As the disease progresses, patients commonly experience chest pain and breathlessness (dyspnea).[asbestos.com]
  • Many cause dyspnea, pleuritic chest pain, or both. Pleuritic chest pain, a vague discomfort or sharp pain that worsens during inspiration, indicates inflammation of the parietal pleura.[merckmanuals.com]
  • pain History of asbestos exposure Diagnosis Biopsy results showed this to be a mesothelioma - a malignancy of the pleura caused by exposure to asbestos Asbestos plaques Calcified asbestos related pleural plaques have a characteristic appearance, and[radiologymasterclass.co.uk]
  • pain or shortness of breath to his or her clinician and monitored for signs and symptoms of chest pain, shortness of breath, hypotension, and infection.[jhoponline.com]
Vascular Disease
  • Other causes of bilateral pleural thickening include uremia and collagen vascular diseases, especially SLE and rheumatoid arthritis.[what-when-how.com]

Workup

  • […] pleural effusion, cytobiochemical analysis of pleural fluid is needed to establish the etiology; however, it is useful for diagnosis only in up to 60% of cases, [7] in around 20% of the cases, etiology often remains unclear even after extensive diagnostic workup[lungindia.com]
  • Preoperative workup included contrasted chest and abdominal CT, bronchoscopy, PFT, 18-FDG PET-scan. All procedures were performed under the general anesthesia with double-lumen tube intubation and single lung ventilation.[jtd.amegroups.com]
X-Ray Abnormal
  • Home » Tutorials » Chest X-ray Tutorials » Chest X-ray Abnormalities » Introduction » 1 2 3 4 5 6 7 8 9 10 11 » Conclusion Key points The pleura and pleural spaces are only visible when abnormal There should be no visible space between the visceral and[radiologymasterclass.co.uk]
Chest X-Ray Abnormal
  • Home » Tutorials » Chest X-ray Tutorials » Chest X-ray Abnormalities » Introduction » 1 2 3 4 5 6 7 8 9 10 11 » Conclusion Key points The pleura and pleural spaces are only visible when abnormal There should be no visible space between the visceral and[radiologymasterclass.co.uk]

Treatment

  • Silon as a sac in the treatment of omphalocele and gastroschisis. J PediatrSurg. 1969;4:3-8. 4. Nuchtern JG, Baxter R, Hatch EI. Nonoperative initial management versus Silon chimney for treatment of giant omphalocele.[healio.com]
  • Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis Case 4-2019: An 18-Year-Old Man with Abdominal Pain and Hematochezia Bridging the Gap Challenge Yourself[nejm.org]
  • Therefore, Thoracoscopy had the double roles of both diagnosis and treatment for pleural effusion. Pre-treatment of thoracoscopy provide further chance for malignant pleural effusion therapy.[gooddoctor.cc]
  • OBJECTIVE: To assess whether pleural adhesions on pretreatment high-resolution computed tomography (HRCT) scans are associated with pneumothorax occurrence after EBV treatment.[ncbi.nlm.nih.gov]
  • EBV treatment has been shown to be a very effective treatment for patients with severe emphysema without collateral ventilation [ 14 ].[karger.com]

Prognosis

  • The presence of pleural adhesions in MPE implies a poor prognosis.[ncbi.nlm.nih.gov]
  • Considering the prognosis, pathologic p1–3 tumors should be managed as a T2 disease for the present. Keywords Lung cancer Surgery Pathology Pleural invasion Prognosis Staging This is a preview of subscription content, log in to check access.[link.springer.com]
  • Prognosis : depends on nature and cause of effusion, generally very guarded.[vetstream.com]
  • These additional studies may be useful in determining prognosis and optimal treatment for a given primary tumor, based on individual characteristics of the tumor.[shortnessofbreath.it]
  • Overall, the thymoma patients did better than the mesothelioma patients, probably due to their better prognosis. 32 Future Directions Clinicians are frustrated that treatment for patients with MPE has changed little since 1935.[jhoponline.com]

Etiology

  • Etiology prior trauma/surgery penetrating chest trauma (e.g. stabbing, gunshot wound ) rib fractures surgical (e.g. pleurectomy) prior infective conditions pleurisy : tuberculosis , viral pulmonary tuberculosis pulmonary abscess empyema sequelae of vascular[radiopaedia.org]
  • No etiological factors had been detected during medical examinations. Chest-computed tomography showed localized bronchiectasis in the right upper lobe, and it was recommended that the patient undergo a VATS lobectomy.[ctsnet.org]
  • Main indication for thoracoscopy in this study was recurrent exudative pleural effusion, whose etiology remained unexplained after initial and repeated cytobiochemical analysis of pleural fluid.[lungindia.com]
  • The etiology is usually unknown, but heart failure, lymphoma, heart worm infection and lymphangiectasia are sometimes implicated. Timecourse Acute. Insidious and progressive.[vetstream.com]
  • Tidal Volume to Accentuate Visualization of Lung Sliding Decrease the Gain and Depth to Accentuate Visualization of Lung Sliding Lung Sliding May Be Less Apparent at the Apices: however, even the slightest movement is significant (“All or Nothing” Rule) Etiology-Lung[mdnxs.com]

Epidemiology

  • Epidemiology Secondary Spontaneous Pneumothorax The incidence of secondary spontaneous pneumothorax depends on the underlying disease process.[what-when-how.com]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology Fluid accumulation in pleural space lung lobes unable to expand dyspnea. True transudates associated with hypoproteinemia.[vetstream.com]

Prevention

  • RESULTS: A significant reduction of adhesions in the PL PG group (p CONCLUSIONS: PL PG may be used to prevent pleural adhesions. The process of fibrinolysis, and fibrosis was though not affected after PLPG administration.[ncbi.nlm.nih.gov]
  • Twenty patients with undiagnosed pleural effusion or thickening and two with associated pulmonary tumour close to the chest wall underwent ET because closed adhesions prevented the induction of an artificial pneumothorax.[ncbi.nlm.nih.gov]
  • Use of preoperative chest sonographic findings to plan trocar placement and to determine the need for an open approach is valuable in helping prevent visceral injury and facilitating video-assisted thoracoscopic surgery.[ncbi.nlm.nih.gov]
  • Prevention of Pleural Adhesions by Bioactive Polypeptides - A Pilot Study. Int J Med Sci 2013; 10(12):1720-1726. doi:10.7150/ijms.6651. Available from[medsci.org]
  • To prevent pleural adhesion formation during staged thoracotomies for kyphosis, a siliconized rubber-coated nylon sheet is interposed between freshly dissected pleural surfaces.[healio.com]

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