WordNet

accumulation of fluid in the pleural cavity (the space between the lungs and the walls of the chest) often resulting from disease of the heart or kidneys

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/05/03 23:23:24」(JST)

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Hydrothorax is a type of pleural effusion in which serous fluid accumulates in the pleural cavity. This specific condition can be related to cirrhosis with ascites in which ascitic fluid leaks into the pleural cavity. Hepatic hydrothorax is often difficult to manage in end-stage liver failure and often fails to respond to therapy.

In similar pleural effusions, the fluid is blood in hemothorax (as in major chest injuries), pus in pyothorax (resulting from chest infections), and lymph in chylothorax (resulting from rupture of the thoracic duct).

Treatment

Treatment of hydrothorax is difficult for several reasons. The underlying condition needs to be corrected; however, often the source of the hydrothorax is end stage liver disease and correctable only by transplant. Chest tube placement should not occur. Other measures such as a TIPS procedure are more effective as they treat the etiology of the hydrothorax, but have complications such as worsened hepatic encephalopathy.

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1. 成人における胸水の診断的評価：初期検査 diagnostic evaluation of a pleural effusion in adults initial testing
2. 成人における胸水の診断的評価：病因未確定に対する追加検査 diagnostic evaluation of pleural effusion in adults additional tests for undetermined etiology
3. 難治性の非癌性胸水のマネージメント management of refractory nonmalignant pleural effusions
4. 成人における胸水の画像検査 imaging of pleural effusions in adults
5. 癌性胸水のマネージメント management of malignant pleural effusions

English Journal

Indwelling pleural catheters for non-malignant effusions: a multicentre review of practice.

Bhatnagar R1, Reid ED2, Corcoran JP3, Bagenal JD4, Pope S5, Clive AO1, Zahan-Evans N1, Froeschle PO6, West D4, Rahman NM7, Chatterji S2, Sivasothy PR2, Maskell NA1.
Thorax.Thorax.2014 Oct;69(10):959-61. doi: 10.1136/thoraxjnl-2013-204563. Epub 2013 Dec 16.
Indwelling pleural catheters (IPCs) are commonly used in the management of malignant pleural effusion (MPE). There is little data on their use in non-malignant conditions. All IPC insertions for non-malignant cases from five large UK centres were found using prospectively maintained databases. Data
PMID 24343783

Pleural Effusion from Leaky Diaphragm-the Hepatic Hydrothorax.

Sharma P1, Nagarajan V.
Journal of general internal medicine.J Gen Intern Med.2014 Sep;29(9):1309. doi: 10.1007/s11606-014-2841-x. Epub 2014 Apr 15.
PMID 24733298

Outcomes of transjugular intrahepatic portosystemic shunts for ascites.

Bercu ZL, Fischman AM.
Seminars in interventional radiology.Semin Intervent Radiol.2014 Sep;31(3):248-51. doi: 10.1055/s-0034-1382792.
Refractory ascites represents a devastating complication of portal hypertension. Transjugular intrahepatic portosystemic shunt (TIPS) is an efficacious option for patients for whom transplant is not an immediate option. Techniques to optimize the hepatic venous pressure gradient and the use of cover
PMID 25177085

Japanese Journal

局所麻酔下胸腔鏡 : 他疾患への有用性の検討

石井聡,竹田雄一郎,佐藤奈穂子,仲剛,飯倉元保,杉山温人
気管支学 : 日本気管支研究会雑誌 35(5), 487-492, 2013-09-25
背景.局所麻酔下胸腔鏡検査は,原因不明胸水に対して局所麻酔にて内科医も施行できる胸腔鏡検査である.悪性胸膜中皮腫・結核性胸膜炎など様々な呼吸器疾患の診断に有用であり,多くの報告がされている.しかし,他疾患への有用性の報告は少ない.方法. 2008年3月から2012年12月に,原因不明胸水76例に対して局所麻酔下胸腔鏡検査を施行した.他疾患に関して,胸腔鏡所見・病理組織学所見などにて診断に至った症例 …
NAID 110009661330

難治性胸水を伴う医原性気胸に対する局所麻酔下胸腔鏡下タルク噴霧

山下貴司,卜部憲和
胸部外科 = The Japanese journal of thoracic surgery 66(6), 460-463, 2013-06
NAID 40019692684

肝性胸水発症後に多発性の肝偽小葉壊死を来した肝硬変の1剖検例

道免和文,稲富裕佑,田中博文 [他],春野政虎,藤原弘明,大野純,清島保,和田裕子,下田慎治,坂井英隆
肝臓 54(4), 277-283, 2013
症例は91歳の女性．約10年前より非アルコール性脂肪肝より進展した肝硬変と診断され，近医で加療されていた．腹水の管理目的にて当科に紹介入院となった．血清アルブミンは3.0 g/dlと低値で，画像上，多量の腹水を伴った肝硬変所見を認めた．ALTは9 IU/lと低値であった．利尿剤投与，腹水穿刺排液による治療を行なったが，入院第36病日に呼吸困難の出現ならびに酸素分圧の低下を来たした．胸部X線にて多量 …
NAID 130003368677