Pleuropulmonary complications of pancreatitis

Kaye, Michael

doi:10.1136/thx.23.3.297

Cited by 134 publications

(69 citation statements)

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“…Although pleural effusion in the presence of perinephric abscess has been reported [3], these effusions are usually small and their nature is not specified.…”

Section: Discussionmentioning

confidence: 99%

“…Pancreatitis is associated with pleural effusion in about 20% of cases, usually left-sided but occasionally right sided or bilateral [1][2][3]. The effusion results from transdiaphragmatic transfer of exudative peritoneal fluid via lymphatic channels.…”

Section: Discussionmentioning

confidence: 99%

“…This is most common in the context of acute pancreatitis, pancreatic pseudocyst [3] or in the presence of subphrenic abscess [4], Perinephric abscess is associated with radiological evidence of pleural effusion in 17% of cases [5], while this is seldom observed with pyelonephritis [6]. We report a case of pyelonephritis in whom the presence of an exudative pleural effusion led to misdiagnosis and delay in the institution of appropriate therapy.…”

Section: Introductionmentioning

confidence: 99%

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Pyelonephritis as a Cause of Pleural Effusion

Berkman

Liss²,

Kramer³

1996

Respiration

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“…Although pleural effusion in the presence of perinephric abscess has been reported [3], these effusions are usually small and their nature is not specified.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pyelonephritis as a Cause of Pleural Effusion

Berkman

Liss²,

Kramer³

1996

Respiration

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“…Hypoxemia of a moderate to severe de gree has been documented in 45-75% of patients with acute pancreatitis [4,6,11,13] and may be related to the pleural effu sions, elevated diaphragms, atelectasis, pneumonia, and pulmonary embolism asso ciated with this disease [5,9,12], Alterna tely, the hypoxemia may be due to the adult respiratory distress syndrome (increasedpermeability pulmonary edema) as manifest ed by bilateral alveolar and interstitial infil trates on chest radiogram and normal or low pulmonary wedge pressure which is clinically detectable in 5-8% of the patients [2,4,13,14], It could be argued that those patients with hypoxemia but with relatively normal chest radiographs, have a 'mild' form of increased alveolar capillary mem brane permeability with the accumulation of lung water leading to closure of airways or alveoli eventuating in ventilation perfusion mismatching. Whether increased alveolar capillary membrane permeability occurs at a subclinical level in a majority of patients with pancreatitis has not been determined.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Alveolar Epithelial Permeability in Surgically Induced Hemorrhagic Pancreatitis in Dogs

Falls¹,

Millen²,

Glauser³

et al. 1980

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The adult respiratory distress syndrome has been associated with acute pancreatitis in 5–8% of patients. To determine, in a quantitative manner, the effects of acute, hemorrhagic pancreatitis on alveolar epithelial permeability, we studied two groups of dogs (group 1 – sham-operated, 7 dogs; group 2 – surgically induced pancreatitis, 7 dogs) and measured the flux of 10,000–20,000 molecular weight dextran and albumin (69,000 molecular weight), from the blood to the saline-filled lung. Following the surgical procedure (day 1), serum amylase levels increased significantly (397 ± 70–1,268 ± 95 dye units) in group 2 but not in group 1. Alveolar epithelial permeability (expressed as T½ time in minutes to 50% equilibration between blood and lung liquid) did not increase in either group for dextrans or albumin. We conclude that experimental acute pancreatitis does not cause an increase in alveolar epithelial permeability for molecular weight substances up to 69,000 daltons.

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“…Bloody pleural effusions are a common occurrence during thoracentesis. Bloody pleural effusion can be caused by malignancy, trauma to chest, tuberculosis, non-tuberculous parapneumonic effusion, systemic lupus erythematosus, pulmonary embolism, fungal infection, anti-coagulant therapy, haemophilia, acute aortic dissection/thoracic aorta aneurysm [1] , pleural endometriosis, dialysis, sarcoidosis [2] , pleuritis associated with amoebic liver abscess [3 , haemorrhagic pancreatitis [4] , pulmonary infarction [5] , microfilaria, post-operative cases of cardiac surgery [6,7] etc. Categorization of bloody pleural effusion is done based on pleural fluid haematocrit in comparison with peripheral blood haematocrit.…”

Section: Introductionmentioning

confidence: 99%

DIAGNOStic evaluation OF BLOODY PLEURAL EFFUSION

Mamatha¹,

Dutta²,

Manjhi³

et al. 2013

jemds

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INTRODUCTION:Pleural involvement is common in various respiratory diseases including inflammatory, infectious, occupational or neoplastic entities. Pleural effusions are a common medical problem and are occasionally intractable. In order to determine the etiology of pleural effusions, it has been widely recommended to assess the appearance of pleural fluid at thoracentesis. Bloody pleural effusions are associated particularly with malignant aetiologies. Pleural fluid analysis is the key component in the diagnosis and management of pleural effusion. Etiology of bloody pleural effusion not only encompasses malignancy but also a diverse set of other clinical entities. AIMS AND OBJECTIVES:• Categorize bloody pleural fluid into blood-tinged, haemorrhagic effusions and hemothorax based on pleural fluid haematocrit • To record their frequency in relation to diagnosis and to evaluate its cause. MATERIAL AND METHODS:The patients who attended the Department of Pulmonary Medicine, V.S.S.M.C.H, Burla during the period of October 2009 to September 2011 were included in this study. RESULTS: In our study all 70 patients with bloody pleural effusion was taken and pleural fluid analysis revealed that the maximum number of patients i.e., 65 (92.85 %) had their pleural fluid protein levels in the exudative range (i.e,≥3.5gm%), remaining 5(7.14%) had in the transudative range (i.e.,≤3gm%). The examination of pleural fluid cytology showed predominantly lymphocytes in 37 (52.85%), RBCs °enerated polymorhonuclear cells in 19 (27.14%), macrophages & mesothelial cells in 6(8.57%), eosinophils in 2(2.85%) & neutrophils in 1(1.42%).Malignant cells were found in the pleural fluid in 11 (15.71%). Malignancy was proved by CT guided FNAC in 10(14.28%) subjects. Bloody pleural effusion due to infection was ORIGINAL ARTICLEJournal of Evolution of Medical and Dental Sciences/ Volume 2/ Issue 2/ January 14, 2013Page-150 predominantly caused due to tuberculosis in 7(53.84%), followed by parasitic aetiology in 3(23.07%), bacterial in 2(15.38%) and unidentified in 1(7.61%). Parasitic aetiology was identified to be due to Entamoeba histolytica in all 3 cases. CONCLUSION: Majority of bloody pleural effusions of infective etiology were caused by tuberculosis, followed by parasitic and bacterial infections. By malignancy, primary site of which was found to be in lung, followed by undiagnosed primary, breast, ovary, oral and Non-Hodgkin's lymphoma in the order of frequency. The second common presentation was blood-tinged effusion caused by traumatic tap or due to thickened pleura. KEYWORDS: Pleural effusions; Hemothorax, Thoracentesis, Haemorrhagic pleural effusion INTRODUCTION:Pleural effusion is accumulation of excessive pleural fluid in pleural space. Several mechanisms underlying pleural effusion include increased permeability of the pleural membrane, increased pulmonary capillary pressure, decreased negative intrapleural pressure, decreased oncotic pressure, and obstructed lymphatic flow. Bloody pleural effusions are a common occurrence...

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Pleuropulmonary complications of pancreatitis

Abstract: Pancreatitis, in common with many other upper abdominal diseases, often leads to pleuropulmonary complications. Radiological evidence of pleuropulmonary abnormality was found in 55% of 58 cases examined retrospectively.

Cited by 134 publications

References 39 publications

Pyelonephritis as a Cause of Pleural Effusion

Pyelonephritis as a Cause of Pleural Effusion

Pulmonary Alveolar Epithelial Permeability in Surgically Induced Hemorrhagic Pancreatitis in Dogs

DIAGNOStic evaluation OF BLOODY PLEURAL EFFUSION

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