September 30, 2020

Definición de Hidrotórax. 01/11/ historia2. {m.} Hidropesía del pecho. HIDROTÓRAX. Fuente: Britannica. Se trata de llevar al paciente indicado, en el tiempo indicado al lugar adecuado. Se siguen las pautas ATLS Se realiza el ABCDE, la evaluación primaria, la. % dandy walker malformation 5 % definicion de metastasis 1 % hidrotorax 1 % hidrotórax 1 % high arched palate.

Author: Volkree Dugal
Country: Bermuda
Language: English (Spanish)
Genre: Environment
Published (Last): 6 December 2008
Pages: 435
PDF File Size: 15.15 Mb
ePub File Size: 5.37 Mb
ISBN: 161-9-57044-472-3
Downloads: 82674
Price: Free* [*Free Regsitration Required]
Uploader: Juzahn

Treatment of hepatic hydrothorax and reducion of chest tube output with octreotide. Servicio de Medicina de Aparato Digestivo.

Patients with hydrothorax refractory to pharmacological treatment can be managed with pleurodesis or transjugular intrahepatic portosystemic shunt TIPSalthough liver transplantation is the definitive treatment TIPS dysfunction was ruled out by doppler ultrasound.

These are the most severely ill and difficult patients. It has also been reported to facilitate chest tube removal 15, The patient had a good response to treatment with progressive decrease in chest tube drainage, allowing chest tube removal without recurrence of pleural effusion.

Hospital 12 de Octubre.

Transyugular intrahepatic portal systemic shunt for the management of symptomatic cirrhotic hydrothorax. We report the case of a patient that developed hepatic hydrothorax as the first complication of liver cirrhosis.

Management is dependent on respiratory symptoms caused by hydrothorax 16 and consist of several therapeutic approaches: It is possible that TIPS and octreotide had a summatory effect on the decrease of portal hypertension.

To prevent adverse outcomes after TIPS placement, patients should be carefully selected, avoiding those with hepatic encephalopathy or ihdrotorax Child C cirrhosis On admission, pleural fluid defijicion met exudative criteria total protein 3.


Video-assited thoracoscopic surgery with talc pleurodesis in the management of symptomatic hepatic hydrothorax. Talc is administered during thoracoscopy, performed to repair diaphragmatic defects if detected.

Physical examination showed decreased breath sounds over the right inferior hemithorax. This has led many authors to contraindicate chest tube placement in these patients This drug has few hisrotorax minor side effects 15, Chest ; 1: Based on good response to octreotide treatment in these cases we considered this treatment for our patient.

Hepatic hydrothorax in the absence of ascites.

Definición de Hidrotórax

Due to the absence of response to fluid and sodium restriction and diuretics she was submitted to thoracentesis and chest tube insertion to alleviate symptoms. There are two reported cases of treatment of refractory hepatic hydrothorax with octreotide in patients without other invasive options because of poor condition. Pathogenesis and treatment of hydrothorax complicating cirrhosis with ascites.

Hydrothorax has not recurred within six months of discharge. We hudrotorax this option for our patient due to the absence of response to previous treatments and with the objective of pleurodesis and detection of diaphragmatic defects, as well as to perform a close examination of the thoracic cavity, taking biopsy samples to definitely exclude malignancy.

On the basis of absence of response to fluid and sodium restriction and diuretics, a chest tube was placed to relieve symptoms, with drainage of cc of fluid per day. Moreover, malignancy was ruled out defibicion cytologic examination of pleural fluid and pleural biopsy. Treatment with octreotide was justified as it has the same effect as TIPS in reducing portosystemic pressure gradient. Blood cell count revealed leukocytosis of Thoracoscopy and talc poudrage in the management of hepatic hydrothorax.


Peste equina africana

This procedure has definiion complications such as excessive protein, fluid and electrolyte depletion. Eur J Gastroenterol hepatol ; Due to the lack of response to diuretics, pleurodesis and TIPS, treatment with octreotide was started with resolution of hydrothorax.

To the best of our knowledge, this is the third reported case of refractory hepatic hydrothorax with response to octreotide. In an attempt to control pleural fluid formation, a minithoracotomy with talc pleurodesis was performed without success. Pleural effusion was complicated by acute prerenal failure due to excessive fluid loss and hypoproteinemia with hypoalbuminemia.

Hidrotórax hepático refractario: tratamiento eficaz con octreótido

She was diagnosed with hepatic hydrothorax with a liver biopsy that revealed early micromacronodular cirrhosis, with moderate activity and focal steatosis. The procedure was unsuccessful maintaining high chest tube drainage that did not allow chest tube removal. There are some reported cases of successful treatment with pleurodesis.