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: Yozshukree Gajas
Country: Tajikistan
Language: English (Spanish)
Genre: Software
Published (Last): 16 July 2005
Pages: 92
PDF File Size: 6.43 Mb
ePub File Size: 4.49 Mb
ISBN: 252-8-17634-768-9
Downloads: 84447
Price: Free* [*Free Regsitration Required]
Uploader: Arashikazahn

This procedure has many complications such as excessive protein, fluid and electrolyte depletion. We considered this option for our patient due to the deefinicion 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.

Hepatic hydrothorax in the absence of ascites. Management is dependent on respiratory symptoms caused by hydrothorax 16 and consist of several therapeutic approaches: On admission, pleural fluid analysis met exudative criteria total protein 3.

After pleurodesis failure, and with hemodynamic evidence of mild portal hypertension hepatic venous pressure gradient: Services of Digestive Diseases and 1 Internal Medicine.

There are two reported hideotorax of treatment of refractory hepatic hydrothorax with octreotide in patients without other invasive options because of poor condition. Over the last few years, two cases of successful treatment of hepatic hydrothorax with octreotide have been reported. Utility and complications of thoracocentesis in cirrhotic patients. There was an initial response after the procedure, with a decrease in chest drainage volume, that did not allow chest tube removal.

Transjugular intrahepatic portosystemic shunt for recurrent hepatic hydrothorax. Curr Opin Pulm Med ; 9: Apart from reducing hirrotorax venous pressure gradient, it improves renal function Chest tube removal is often impossible due to high volume drainage. Alonso-Navas 1 and J. The procedure was unsuccessful maintaining high chest tube drainage that did not allow chest tube removal. Besides, she developed hepatic encephalopathy that responded to conventional treatment.


Other laboratory values were as follows: Based on good response to octreotide treatment hidrotoarx these cases we considered this treatment for our patient. After pleurodesis failure and once excluded etiologies for hydrothorax other than liver disease, our patient underwent a hemodynamic study.

Hidrotórax hepático refractario: tratamiento eficaz con octreótido

She was admitted to our hospital one month later with recurrent right hydrothorax. In the reported cases, the effect was dose dependent since higher doses led to greater reduction of drainage volume.

Initial treatment is similar to that of hydropic decompensation and it consists of fluid hivrotorax sodium restriction and diuretics. Hospital 12 de Octubre. Treatment with octreotide was justified as it has the same effect as TIPS in reducing portosystemic pressure gradient. We report the case of a patient that developed hepatic hydrothorax as the first complication of liver cirrhosis.

We decided to continue treatment for several days by subcutaneous administration before discharge. This has led many authors to contraindicate hivrotorax tube placement in these patients To the best of our knowledge, this is the third reported case of refractory hepatic hydrothorax with complete and sustained response to octreotide. Video-assited thoracoscopic surgery with talc pleurodesis in the management of symptomatic hepatic hydrothorax.

According to literature, TIPS is the most effective treatment for refractory hepatic hydrothorax and it is considered one of the indications for this technique 9,15, No recurrence of hydrothorax or ascites has occurred within definifion months of discharge with a 25 mg dose of aldactone daily. Chest ; 1: Currently, the most accepted mechanism, involves the passage of ascitic fluid from the peritoneal cavity into the pleural space through diaphragmatic defects Patients with severe dysnea often require chest tube placement, which is also used to definicikn iatrogenic or spontaneous infection of pleural effusion.


Pleural effusion is usually a transudate. Igarzabal 1T. This drug has few and minor side effects 15, Moreover, hidrotoraax was ruled out by definiicon examination of pleural fluid and pleural biopsy. Findings allowed the exclusion of tumoral and infectious diseases and the presence of signs of portal hypertension led to the diagnosis of cirrhosis as the cause of hydrothorax. We administered the same doses as those reported in the literature: Gastroenterol Hepatol ; 25 3: Treatment of hepatic hydrothorax and reducion of chest tube output with octreotide.

In an attempt to control pleural fluid formation, a minithoracotomy with talc pleurodesis was performed without success.

Ann Intern Med ; Refractory hepatic hydrothorax is defined as pleural effusion that definickon despite adequate treatment with the highest tolerable dose of diuretics. These are the most severely ill and difficult patients.

Definición de Hidrotórax

Doppler ultrasound revealed signs of chronic liver disease without morphologic nor hemodynamic signs of portal hypertension, mild ascites and right pleural effusion. The only definitive treatment is liver transplantation 19,20and it must be always considered in these patients.

J Clin Gastroenterol ; Our patient had progressive improvement, allowing chest tube drfinicion after five days of treatment Fig. Arch Intern Med ; The management of this complication is usually difficult, with few therapeutical options. Its pathophysiology is unclear and it involves movement of ascitic fluid from the peritoneal cavity to the pleural space through micro- or macroscopic diaphragmatic defects Patients with hydrothorax refractory to pharmacological treatment can be managed with pleurodesis or transjugular intrahepatic portosystemic shunt TIPSalthough liver transplantation is the definitive treatment