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pleural effusion diagnosis, ultrasound

Francesca M Trovato, Daniela Catalano, Guglielmo M Trovato
Imaging workup of patients referred for elective assessment of chest disease requires an articulated approach: Imaging is asked for achieving timely diagnosis. The concurrent or subsequent use of thoracic ultrasound (TUS) with conventional (chest X-rays-) and more advanced imaging procedures (computed tomography and magnetic resonance imaging) implies advantages, limitations and actual problems. Indeed, despite TUS may provide useful imaging of pleura, lung and heart disease, emergency scenarios are currently the most warranted field of application of TUS: Pleural effusion, pneumothorax, lung consolidation...
September 28, 2016: World Journal of Radiology
Itaru Iwama, Moriyasu Kohama
Unilateral lung whiteout is not a common pediatric chest radiograph finding, but when it is encountered, timely and accurate interpretations of the radiograph are required because life-threatening respiratory failure can be associated. Lung whiteout may result from several conditions, and the differential diagnosis has a broad range. We describe 4 pediatric patients with different etiologies of unilateral lung whiteout: a large pleural effusion, mainstem bronchial plugging with a large cast, a mediastinal tumor, and consolidation...
September 24, 2016: Pediatric Emergency Care
C Le Stradic, J Aroulandom, H Kotobi, D Pariente, C Gaboran, J Lemale, B Dubern, P Tounian
INTRODUCTION: Duodenal duplications are rare congenital malformations whose revealing signs are highly variable and nonspecific. OBSERVATION: We report the case of a female infant who presented with neonatal acute pancreatitis complicated by recurrent ascites, profound hypoalbuminemia responsible for pleural and pericardial effusions, revealing a duodenal duplication cyst. The unusual and original clinical presentation as well as the difficulty detecting the duplication radiologically delayed the diagnosis...
October 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
José M Porcel
Pleural tuberculosis (TB) remains difficult to diagnose. In about two-thirds of the cases the diagnosis is reliant upon clinical suspicion along with consistent fluid biochemistries (i.e., lymphocytic predominant exudates) and exclusion of other potential causes for the effusion. Microbiological methods for a confirmatory diagnosis of pleural TB, which include acid-fast smears (Ziehl-Nelseen), cultures on solid media (Lowenstein-Jensen) and polymerase chain reaction tests from either pleural fluid or sputum samples, remain suboptimal since they are positive in only a minority of patients...
August 2016: Annals of Translational Medicine
Amanullah Abbasi, Abdul Rabb Bhutto, Mohammad Tanveer Alam, Muhammad Aurangzaib, Mohammad Masroor
OBJECTIVE: To determine the frequency of hepatic hydrothorax and its association with Child Pugh Class in patients with liver cirrhosis. STUDY DESIGN: Descriptive, analytical study. PLACE AND DURATION OF STUDY: Jinnah Postgraduate Medical Centre, Karachi, Medical Unit-III, (Ward- 7), from June 2012 to May 2013. METHODOLOGY: All patients with established diagnosis of decompensated chronic liver disease were included. Detailed history, thorough physical examination, routine laboratory investigations, chest X-ray and abdominal ultrasound were carried out in all patients to find out the presence of pleural effusion and ascites, respectively...
July 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Chiara Mozzini, Anna Maria Fratta Pasini, Ulisse Garbin, Luciano Cominacini
BACKGROUND: Lung ultrasound (LUS) represents an emerging technique for bedside chest imaging in different clinical settings. A standardized approach allows the diagnosis, the quantification, and the follow-up of different conditions for which acute respiratory failure is the main clinical presentation. The aim of this study was to test what skill targets could be achieved in LUS, with a short-training course offered to 19 Medical Doctors attending the certification board school in Internal Medicine at the University of Verona, Italy...
December 2016: Critical Ultrasound Journal
Yiorgos Alexandros Cavayas, Martin Girard, Georges Desjardins, André Y Denault
BACKGROUND: Acute deterioration in respiratory status commonly occurs in patients who cannot be transported for imaging studies, particularly during surgical procedures and in critical care settings. Transthoracic lung ultrasonography has been developed to allow rapid diagnosis of respiratory conditions at the bedside. Nevertheless, the thorax is not always accessible, especially in the perioperative setting. Transesophageal lung ultrasonography (TELU) can be used to circumvent this problem...
November 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Justin K Lui, Gisela I Banauch
Bedside goal-directed ultrasound is a powerful tool for rapid differential diagnosis and monitoring of cardiopulmonary disease in the critically ill patient population. The bedside intensivist is in a unique position to integrate ultrasound findings with the overall clinical situation. Medically critically ill patients who require urgent bedside diagnostic assessment fall into 2 categories: (1) acute respiratory failure and (2) hemodynamic derangements. The first portion of this review outlines the diagnostic role of bedside ultrasound in the medically critically ill patient population for the diagnosis and treatment of acute respiratory failure, acute respiratory distress, and severe hypoxemia...
July 8, 2016: Journal of Intensive Care Medicine
Astha Chichra, Mina Makaryus, Parag Chaudhri, Mangala Narasimhan
Bedside ultrasonographic assessment of the lung and pleura provides rapid, noninvasive, and essential information in diagnosis and management of various pulmonary conditions. Ultrasonography helps in diagnosing common conditions, including consolidation, interstitial syndrome, pleural effusions and masses, pneumothorax, and diaphragmatic dysfunction. It provides procedural guidance for various pulmonary procedures, including thoracentesis, chest tube insertion, transthoracic aspiration, and biopsies. This article describes major applications of ultrasonography for the pulmonary consultant along with illustrative figures and videos...
2016: Clinical Medicine Insights. Circulatory, Respiratory and Pulmonary Medicine
Shirin Sayyahfar, Fariba Jahangiri, Elham Zarei
Acute appendicitis is an uncommon and challenging disease in infancy. Usually, the clinical presentation in neonates and infants is non-specific and varies depending on the age of the child and duration of the disease. Diagnosis of incomplete and atypical Kawasaki disease (KD) in infants is also a challenging aspect and there is no gold standard for this diagnosis and sometimes fever is the only symptom that could be found. Herein, we report a 6-month infant with a 7 days of fever and bilateral pleural effusion, elevated erythrocyte sedimentation rate, thrombocytosis, hypo-albominemia, normal abdominal ultrasound, and primary diagnosis of KD...
June 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Yang Ting, L I Yang, Zhao Juan, Wei Xing, Yang Xiao Feng
Previous clinical reports of benign ovarian thecoma, associated with hydrothorax, are rare. The present study presents the case of a 58-year-old women exhibiting right massive pleural effusions and elevated cancer antigen (CA)125, and a pelvic ultrasound revealed a hypoechoic mass. An exploratory laparotomy was subsequently performed. During the surgery, the left ovary measured 20×15×15 cm and had a smooth surface with no excrescences or papillary projections. The patient underwent right salpingo-oophorectomy...
June 2016: Molecular and Clinical Oncology
Sachita P Shah, Sachin P Shah, Reginald Fils-Aime, Walkens Desir, Joanel Joasil, David M Venesy, Krithika Meera Muruganandan
BACKGROUND: The diagnosis and management of acutely dyspneic patients in resource-limited developing world settings poses a particular challenge. Focused cardiopulmonary ultrasound (CPUS) may assist in the emergency diagnosis and management of patients with acute dyspnea by identifying left ventricular systolic dysfunction, pericardial effusion, interstitial pulmonary edema, and pleural effusion. We sought to assess the accuracy of emergency providers performing CPUS after a training intervention in a limited-resource setting; a secondary objective was to assess the ability of CPUS to affect change of clinician diagnostic assessment and acute management in patients presenting with undifferentiated dyspnea...
December 2016: Critical Ultrasound Journal
J R Liu, W B Shen, Z Wen, R An, C J Zhou, S Y Zhao
OBJECTIVE: To analyze the clinical characteristics and diagnosis of 2 cases with diffuse pulmonary lymphatic disease. METHOD: Clinical manifestations of the children were retrospectively analyzed. Two patients were both from Beijing Children Hospital in 2013 and 2014.Diffuse pulmonary lymphatic disease was diagnosed by pathology of pleura in case 1 and by lymphoscintigraphy in case 2. RESULT: The first patient was a male aged 10-year-5-month who presented with a history of pleural effusion for 2 years...
May 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Anna C Bibby, Nick A Maskell
PURPOSE OF REVIEW: Pleural biopsies are often necessary if a pleural effusion remains undiagnosed after radiological imaging and pleural fluid analysis. There are many methods of obtaining pleural biopsies, including blind or image-guided procedures, closed-bevel or cutting-edge needles, and percutaneous or thoracoscopic approaches. This article will review recent research relating to these methods, aiming to provide an overview of the strengths and limitations of each technique. RECENT FINDINGS: Historically pleural biopsies were undertaken using a blind closed 'Abrams' needle method...
July 2016: Current Opinion in Pulmonary Medicine
Shruti Chandak, Ashutosh Kumar
BACKGROUND: Dengue fever (DF) is a viral hemorrhagic fever causing severe morbidity and mortality in affected patients. AIMS: The purpose of our study was to evaluate the changing trends in radiological findings in DF, to find if ultrasound is useful in the diagnosis of DF during an epidemic in absence of serological tests, and also to investigate the effects of DF in pregnancy. MATERIALS AND METHODS: A prospective study was conducted in 2013 comprising of 400 patients who were serologically positive for dengue...
February 2016: North American Journal of Medical Sciences
Daniel R Rissi, Kerry D Kirby, Susan Sanchez
Our study describes a case of systemic Trichosporon loubieri infection in a cat with acute dyspnea, anorexia, and aggressiveness. Physical examination revealed multiple ulcerative cutaneous lesions on the abdomen, neck, and thorax. Thoracic radiographs and ultrasound showed multiple mediastinal nodules and marked pleural effusion, respectively. A cutaneous biopsy from the ulcerated wounds revealed necrogranulomatous dermatitis and panniculitis with numerous intralesional fungal hyphae. Fungal culture on fresh swab samples from the cutaneous lesions yielded growth of a fungal organism that was further identified as Trichosporon loubieri by PCR and DNA sequencing...
May 2016: Journal of Veterinary Diagnostic Investigation
Saman Ratnayake, Ali Ammar, Rodd Rezvani, Greti Petersen
We present a case of a 65-year-old Hispanic man with a history of disseminated cutaneous coccidioidomycosis who presented to the emergency room for progressively worsening abdominal pain associated with shortness of breath. The patient was found to have pleural effusion and moderate ascites on physical examination. Abdominal ultrasound and computed tomography scan were consistent with moderate ascites and portal hypertension but negative for both liver cirrhosis and for venous or arterial thrombosis. Cytology of ascitic fluid was suggestive of portal hypertension and was negative for infection...
October 2015: Journal of Investigative Medicine High Impact Case Reports
Zhi Li, Ming Zhu, Suzhen Dong, Zhiqin Luo, Zhenghua Fei, Xiangming Fang, Linghong Qi
OBJECTIVE: To investigate the clinical value of prenatal MRI in the diagnosis and differential diagnosis of congenital bronchopulmonary sequestration (BPS). METHODS: From January 2009 to December 2014, 16 fetuses with BPS were diagnosed by fetal MRI in Huzhou Maternity and Child Care Hospital and Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine. The clinical data of these cases were analyzed retrospectively. All were singleton pregnancy, and MRI was carried out within 24-48 hours after routine prenatal ultrasound...
January 2016: Zhonghua Fu Chan Ke za Zhi
Cristiane Rúbia Ferreira, Verônica Sibre, Regina Schultz, Ana Maria Andrello Gonçalves Pereira de Melo, Silvia Maria Ibidi, Jackeline Della Torre
Firstly described by Rudolf Virchow in the 19th century, congenital generalized lymphangiectasia is a rare entity characterized by dilation of lymphatic vessels, and was recently classified in primary or secondary lymphangiectasia. Generalized forms may be diagnosed during pre-natal follow-up with ultrasound examination, and, depending on its severity, the newborn outcome is very poor. The authors report the case of a female newborn with a previous diagnosis of fetal hydropsy who was born after a full-term gestation with respiratory failure due to bilateral voluminous pleural effusion and ascites...
October 2015: Autopsy & case reports
Keyvan Razazi, Jean-François Deux, Nicolas de Prost, Florence Boissier, Elise Cuquemelle, Frédéric Galactéros, Alain Rahmouni, Bernard Maître, Christian Brun-Buisson, Armand Mekontso Dessap
Lung ultrasound (LU) is increasingly used to assess pleural and lung disease in intensive care unit (ICU) and emergency unit at the bedside. We assessed the performance of bedside chest radiograph (CR) and LU during severe acute chest syndrome (ACS), using computed tomography (CT) as the reference standard. We prospectively explored 44 ACS episodes (in 41 patients) admitted to the medical ICU. Three imaging findings were evaluated (consolidation, ground-glass opacities, and pleural effusion). A score was used to quantify and compare loss of lung aeration with each technique and assess its association with outcome...
February 2016: Medicine (Baltimore)
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