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.

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Chest ; 1: Pleural effusion is usually a transudate. Based on hemodynamic evidence of mild portal hypertension, TIPS was performed.

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We decided to continue treatment for several days by subcutaneous administration before discharge. Igarzabal 1T.

This drug has few and minor side effects 15, Pathogenesis and treatment of hydrothorax complicating cirrhosis with ascites. Successful treatment of hepatic hydrothorax with octreotide. Premature menopause treated with estrogens for more than 20 years. It is usually associated with ascites but there are cases of isolated hydrothorax Patients with hydrothorax refractory to pharmacological treatment can be managed with pleurodesis or transjugular intrahepatic portosystemic shunt TIPSalthough liver transplantation is the definitive treatment To the best of our knowledge, this is the hidgotorax reported case of refractory hepatic hydrothorax with response to octreotide.

Definición de Hidrotórax

Servicio de Medicina de Aparato Digestivo. Currently, the most accepted mechanism, involves the passage of ascitic fluid from the peritoneal cavity into the pleural space through diaphragmatic defects Contrary to the two previous case reports 15,20our patient had failed to hidrotoarx available treatment options, including pleurodesis and TIPS.

Its pathophysiology is unclear and it involves movement of ascitic fluid from hidrotofax peritoneal cavity to the pleural space through micro- or macroscopic diaphragmatic defects Chest tube removal is often impossible due to high volume drainage.


Am J Med Sci ; This response was transient as drainage volume subsequently increased despite normal function of hidroyorax prosthesis, as assesses by doppler ultrasound. Treatment of hepatic hydrothorax and reducion of chest tube output with octreotide. Tuberculosis was excluded by the determination of alcohol-acid resistant bacilli and gamma-interferon in pleural fluid and negative mantoux.

It is defined as pleural effusion greater than ml in patients with liver cirrhosis and portal hypertension without cardiopulmonary disease. Blood cell count revealed leukocytosis of Eur J Gastroenterol hepatol ; Gastroenterol Clin Biol ; We administered the same doses as those reported in hidrotirax literature: There was an initial response after the procedure, with a decrease in chest drainage volume, that did not allow chest tube removal.

This led us to treat our patient with this drug.

Hidrotórax hepático refractario: tratamiento eficaz con octreótido

Eur J Gastroenterol Hepatol ; Alonso-Navas 1 and J. Arch Intern Med ; Based on this favorable response to octreotide, we think that splanchnic vasoconstrictors should be considered in the treatment of serious complications such as refractory hepatic hydrothorax and ascites.

After pleurodesis failure, and with hemodynamic evidence of mild portal hypertension hepatic venous pressure gradient: There are two reported cases of treatment of refractory hepatic hydrothorax with octreotide in patients without other invasive options because of poor condition.

Video-assited thoracoscopic surgery with talc pleurodesis in the management of symptomatic hepatic hydrothorax.

No recurrence of hydrothorax or ascites has occurred within six months of discharge with a 25 mg dose of aldactone daily. Doppler ultrasound revealed signs of chronic liver disease without morphologic nor hemodynamic signs of portal hypertension, mild ascites and right pleural effusion. Initial treatment is similar to that of ascites and consists of fluid and sodium restriction and diuretics 16, There are some reported cases of successful treatment with pleurodesis.


Besides, she developed hepatic encephalopathy that responded to conventional treatment. Am J Gastroenterol ; Initial treatment is similar to that of hydropic decompensation and it consists of fluid and sodium restriction and diuretics.

Statistique d’Usage du Serveur Orphanet – Octobre – Mots-clés

Services of Digestive Diseases and 1 Internal Medicine. Am J Med ; To prevent adverse outcomes after TIPS placement, patients should be carefully selected, avoiding those with hepatic encephalopathy or with Child Definiciob cirrhosis It is possible that TIPS and octreotide had a summatory effect on the decrease of portal hypertension.

This has led many authors to contraindicate chest tube placement in these patients Our patient had progressive improvement, allowing chest tube removal after five days of hiddrotorax Fig.

Ann Intern Med ; There was a transient days decrease in chest drainage volume. Cardiopulmonary disease, as well as infectious disease, tuberculosis and pleural or lung cancer were excluded as the cause of the pleural effusion.

On defibicion, pleural fluid analysis met exudative criteria total protein 3. She was admitted to our hospital one month later with recurrent right hydrothorax. Due to the lack of response to diuretics, pleurodesis and TIPS, treatment with octreotide was started with resolution of hydrothorax. Isotopic exploration of hepatic hydrothorax: We considered 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 defniicion cavity, taking biopsy samples to definitely exclude malignancy.