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Ventriculo Pleural Shunt Tips

Pleural Effusion - Everything You Must Know About It!

MBBS, MD - Respiratory Medicine , Trained In Treating Sleep Disorder , Trained In Interventinal Bronchoscopy , Trained In Medical Thoracoscopy , Trained In Rigid Bronchoscopy
Pulmonologist, Delhi
Pleural Effusion - Everything You Must Know About It!

Thin membranes on the surface of lungs and inside of the chest cavity are known as Pleura. The space between them is known as Pleural space. Pleural Effusion is a common problem where fluid accumulates in the Pleural space. A person may have it if he or she has any heart or lung problems, such as Pneumonia, Tuberculosis, Pulmonary Embolism, etc. Other problems not related to lung or heart, such as Hypothyroidism, Nephrotic Syndrome, Rheumatoid Arthritis, Ovarian Tumours, etc. may also lead to Pleural Effusion.

Causes of Pleural Effusion

There may be a wide range of causes for Pleural Effusion. The most common causes are:

Leakage of fluid from organs: If someone has a Heart problem and it is not pumping blood properly, there may be accumulation of fluid in the body. This fluid may leak into the Pleural space. If the Liver or Kidney is not working properly, it may also give rise to accumulation of fluid. This fluid build-up may leak into the Pleural space.

Infections: Infections like Bacterial Pneumonia and Tuberculosis are major reasons for Pleural Effusion.

Autoimmune conditions: Autoimmune conditions like Lupus Erythematosus, Rheumatoid Arthritis, etc. may also cause such condition.

Pulmonary embolism: Embolism leads to blockage in Artery in one of the lungs. This can lead to Pleural Effusion.

Lung cancer: Lung Cancer often causes Pleural Effusion. Cancer spreading to the Lungs from other organs too can precipitate the condition.

Pleural Effusion Symptoms

Symptoms of this disease show up only when the fluid build-up is moderate or large. Symptoms include shortness of breath, fever, chest pain, aggravation during deep breathing, cough, etc. These are the most pronounced symptoms of this condition. One may also have chills and night sweats.

Treatment of Pleural Effusion

These are some of the common treatment steps for this disease:

● The first stage in treatment is Chest X-ray or CT Scan to ascertain the dimension of fluid accumulation.
● The doctor may then draw out a sample of the fluid to test it for infection. If an infection is detected, doctor may prescribe antibiotics.
● If the fluid accumulation is less, the doctor may not consider it necessary to draw out the fluid.
● If there is a Heart problem, the doctor may prescribe medicines for the same.
● If the Effusion is large, a doctor would most likely perform a Thoracentesis to drain the fluid and ease the symptoms.
● If the Effusion keeps coming back, the doctor may consider a Pleural Drain. A catheter is put into the Pleural space for a long time for that.
● The doctor may also inject an inflammatory substance into the Pleural space. This inflames the Pleura and helps them bond with each other tightly. This is known as Pleurodesis and can heal the problem.

Pleural Effusion is a medical condition which is not to be taken lightly. One must consult an experienced doctor for its treatment, as it may worsen over time.

1 person found this helpful

Pleural Effusion - Most Effective Treatment Methods!

MD - Pulmonary, DTCD
Pulmonologist, Faridabad
Pleural Effusion - Most Effective Treatment Methods!

Pleural effusion, in medical terms, is a condition characterized by an abnormal accumulation of fluids in the pleural space. The pleural space is essentially the region between the tissues that form the lining of the lungs and the chest cavity. The fluid that builds up in the pleural space may either be protein-rich (Exudative Pleural Effusions) or watery (Transudative Pleural Effusions) in nature, thus helping doctors ascertain the cause of the pleural effusion.

  1. Exudative Pleural Effusions are often found to be triggered by medical conditions such as Cancer, Inflammatory diseases, Kidney disorder, Pneumonia, or Pulmonary embolism.
  2. Transudative Pleural Effusions, on the other hand, may be triggered by Cirrhosis, Heart Attack and Pulmonary embolism. People undergoing an open heart surgery are also susceptible to Transudative Pleural Effusions.

Further, people with Meigs’ syndrome, autoimmune diseases, congestive heart problems, Chylothorax, Ovarian hyperstimulation syndrome, or Tuberculosis also stand a higher risk of suffering from pleural effusions.

Symptoms:
In most of the affected individuals, pleural effusions trigger

  • Shortness of breath or difficulties in breathing, a condition called Dyspnea.
  • Some individuals also experience chest pain, dry cough, and Orthopnea (difficulty in breathing especially while in lying flat or in a sleeping position).

Treatment:
The first step towards effective treatment includes identifying the underlying health problem that triggered pleural effusions. Doctors work towards

  1. Treating the pleural effusions.
  2. Ensuring that the condition (Pleural effusions) does not recur.
  3. Measures are also taken to treat the health problem that resulted in pleural effusions.

In case of severe breathing troubles, doctors may perform Thoracentesis, an invasive procedure whereby the doctor carefully inserts a needle through the chest wall to drain out the excess fluids that have accumulated in the pleural space. While Thoracentesis is known to produce fruitful results, people with chronic lung disorders or a lung surgery should refrain from this procedure.

In the case of pleural effusions resulting from congestive heart failure, the use of diuretics come as a great relief. To prevent the recurrence of the condition or to deal with malignant pleural effusions, doctors may also opt for Pleural sclerosis or Pleurodesis, which involves the removal of excess pleural fluid from the pleural space.

The doctor slightly irritates the tissues of the pleural lining to create a scar. It is this scarring that results in the fusion of the two pleural layers thus filling the space between the layers and preventing the recurrence of pleural effusion. In malignant pleural effusions, patients may also require chemotherapy or radiation therapy. In extreme cases, doctors may perform Video-Assisted Thoracoscopic Surgery (VATS). In VATS, ½ -inch long incisions (1-2) are made to drain out the pleural fluid. To avoid recurrence of the effusion, an antibiotic or a sterile talc is placed inside during the surgery.

In case of pleural effusion resulting in infection at the pleural space, an Open Thoracic Surgery (Thoracotomy) is carried out to treat the condition.

While there are several treatment methods for pleural effusion, proper identification of the underlying cause is imperative to recommend the line of treatment best suited for the patient.

In case you have a concern or query you can always consult an expert & get answers to your questions!

3576 people found this helpful

Normal Pressure Hydrocephalus

MBBS, MS - General Surgery, M Ch. neurosurgery
Neurosurgeon, Hubli-Dharwad
Normal Pressure Hydrocephalus

Normal pressure hydrocephalus is one of the old age problem. CSF tap test helps as a prognostic indicator for shunt surgery.

2 people found this helpful

Thoracoscopy Its Purpose And Uses!

MBBS, MD -Pulmonary Medicine-Tuberculosis ,Respiratory Disease Medicine , Diploma in Tuberculosis and Chest Diseases (DTCD), European Diploma in Respiratory Medicine
Pulmonologist, Delhi

Purpose of the Thoracoscopy:

- To visually inspect the lungs
- To obtain tissue biopsies or fluid samples from the lungs
- To remove excess fluid in the pleural cavity or pleural cysts
- To evaluate patients with pulmonary disease or abnormalities
- To obtain a tissue sample (biopsy) for further evaluation and to diagnose inflammation, infection, fibrosis and cancer

1 person found this helpful

The Surgical Treatment For Portal Hypertension!

Dr. Siddharth Jain 90% (97 ratings)
FELLOWSHIP IN HEPATOBILIARY AND LIVER TRANSPLANT SURGERY, Fellowship in Abdominal Multi Organ Transplant Surgery, MS - General Surgery, MBBS Bachelor of Medicine and Bachelor of Surgery
Gastroenterologist, Delhi
The Surgical Treatment For Portal Hypertension!

There are veins which carry blood from the various digestive organs to the liver. When there is an obstruction in the free flow of blood in the liver, it increases the pressure and is known as portal hypertension. This increased blood pressure stresses the blood vessels in the esophagus, stomach, and other digestive organs and results in internal bleeding.

What causes portal hypertension?
Cirrhosis is the most common cause of portal hypertension. The cirrhosis could be a result of excessive consumption of alcohol, chronic hepatitis, or thrombosis in the liver vessels. Blood clots in the portal vein are schistosomiasis ( a parasitic infection) are some other causes of portal hypertension. It is also important to know that in some cases, the causes of this condition remain unknown.

What are the symptoms?
Although, the symptoms of portal hypertension may not be very evident until you identify that there is some damage in the liver. the chances of developing a portal hypertension are increased if you suffer from a liver disease.

  • Ascites, which is fluid accumulation in the abdominal cavity
  • Bleeding in the abdominal vessels
  • Blood in the stools and/or vomitus (black tarry stools or blood in the vomitus)
  • Reduced platelet count
  • Encephalopathy, fluid accumulation in the brain, which can lead to confusion and other issues

How can it be managed?
Once diagnosed, treatment of portal hypertension is at two levels.
At the first level, dietary and lifestyle changes and medical treatment should suffice.

  1. Alcohol, a street drug, and tobacco use should be completely stopped. Sodium and protein intake should be reduced.
  2. Avoid taking any over-the-counter medications without consulting a medical personnel.
  3. Have a good, balanced nutrition
  4. Medications like propranolol are given to control blood pressure
  5. Medications are also given to prevent internal bleeding
  6. If there is encephalopathy, then lactulose is given to clear confusion
  7. The ends of the bleeding vessels are tied and cut off (ligated) endoscopically, and this is known as sclerotherapy. Alternately, bands may be applied to the cut vessels to prevent further bleeding. This is known as banding.

If this first line does not work, then the next level of interventional therapy is initiated.

  • TIPS, which is a transjugular intrahepatic portosystemic shunt, which is a shunt that is placed into the liver to reduce pressure.
  • Distal splenorenal shunt (DRSR) is when a shunt or link is created between the splenic vein and the left kidney vein. This also helps control variceal pressure and bleeding.
  • Both these shunts are widely performed and require follow up once in 6 months to ensure they are performing well and without any blockages.

Other options:

  • In cases where a shunt is not possible, then devascularization is done. This involves removal of the bleeding varices.
  • The fluid in the abdomen may be removed surgically by paracentesis.
  • As a last option, a liver transplant surgery may also be considered.

So, while portal hypertension definitely is a serious medical condition, there are different levels of treatment. The important thing is to alert yourself once any symptoms set in. Early intervention always ensures minimal intervention and good prognosis.

In case you have a concern or query you can always consult an expert & get answers to your questions!

2538 people found this helpful

Try Surgery For Portal Hypertension!

MS - General Surgery, DNB - Surgical Gastroenterology, Fellow HPB Surgery & Liver Transplant
Surgical Gastroenterologist, Ernakulam
Try Surgery For Portal Hypertension!

There are veins which carry blood from the various digestive organs to the liver. When there is an obstruction in the free flow of blood in the liver, it increases the pressure and is known as portal hypertension. This increased blood pressure stresses the blood vessels in the esophagus, stomach, and other digestive organs and results in internal bleeding.

What causes portal hypertension?
Cirrhosis is the most common cause of portal hypertension. The cirrhosis could be a result of excessive consumption of alcohol, chronic hepatitis, or thrombosis in the liver vessels. Blood clots in the portal vein are schistosomiasis ( a parasitic infection) are some other causes of portal hypertension. It is also important to know that in some cases, the causes of this condition remain unknown.

What are the symptoms?
Although, the symptoms of portal hypertension may not be very evident until you identify that there is some damage in the liver. the chances of developing a portal hypertension are increased if you suffer from a liver disease.

  • Ascites, which is fluid accumulation in the abdominal cavity
  • Bleeding in the abdominal vessels
  • Blood in the stools and/or vomitus (black tarry stools or blood in the vomitus)
  • Reduced platelet count
  • Encephalopathy, fluid accumulation in the brain, which can lead to confusion and other issues

How can it be managed?
Once diagnosed, treatment of portal hypertension is at two levels.
At the first level, dietary and lifestyle changes and medical treatment should suffice.

  1. Alcohol, a street drug, and tobacco use should be completely stopped. Sodium and protein intake should be reduced.
  2. Avoid taking any over-the-counter medications without consulting a medical personnel.
  3. Have a good, balanced nutrition
  4. Medications like propranolol are given to control blood pressure
  5. Medications are also given to prevent internal bleeding
  6. If there is encephalopathy, then lactulose is given to clear confusion
  7. The ends of the bleeding vessels are tied and cut off (ligated) endoscopically, and this is known as sclerotherapy. Alternately, bands may be applied to the cut vessels to prevent further bleeding. This is known as banding.

If this first line does not work, then the next level of interventional therapy is initiated.

  • TIPS, which is a transjugular intrahepatic portosystemic shunt, which is a shunt that is placed into the liver to reduce pressure.
  • Distal splenorenal shunt (DRSR) is when a shunt or link is created between the splenic vein and the left kidney vein. This also helps control variceal pressure and bleeding.
  • Both these shunts are widely performed and require follow up once in 6 months to ensure they are performing well and without any blockages.

Other options:

  • In cases where a shunt is not possible, then devascularization is done. This involves removal of the bleeding varices.
  • The fluid in the abdomen may be removed surgically by paracentesis.
  • As a last option, a liver transplant surgery may also be considered.

So, while portal hypertension definitely is a serious medical condition, there are different levels of treatment. The important thing is to alert yourself once any symptoms set in. Early intervention always ensures minimal intervention and good prognosis.

In case you have a concern or query you can always consult an expert & get answers to your questions!

2709 people found this helpful

Brain Tumor - Types Of Surgeries Available!

DNB (Neuro-Surgeon), MBBS
Neurosurgeon, Delhi
Brain Tumor - Types Of Surgeries Available!

Although surgery is considered to be the first step of treatment in any form of tumor but its feasibility depends upon the type, size and location of the tumor. It is not necessary that every kind of brain tumor might require surgery.

Indications of Brain Tumor Surgery

  • Diagnosis of the type of tumor by taking a sample of the tumor for laboratory examination
  • Complete resection of tumor
  • Removal of the tumor as much as possible to slow down its growth and improve the symptoms.
  • Remove the tumor in order to help other treatment
  • Provide direct access for other forms of treatment like chemotherapy, radiotherapy etc.
  • To relieve pressure caused by tumor on surrounding structures

Types of Brain Tumor Surgery

The different types of surgery that are performed in cases of brain tumor include the following:

Craniotomy: Craniotomy is the most commonly performed procedure to remove brain tumor along with a piece of bone. The removed bone is replaced and the tumor is sent for histopathology (biopsy). The surgery is performed using a high end microscope by any of the following techniques:

  • Extended bifrontal craniotomy
  • "Eyebrow" craniotomy (supra-orbital craniotomy)
  • "Keyhole" craniotomy (retro-sigmoid craniotomy)
  • Orbitozygomatic craniotomy
  • Translabyrinthine craniotomy

Shunt: A narrow piece of flexible tube with a pressure regulated valve in between is called a shunt. This is used to relieve the intracranial pressure caused by obstruction of the natural brain fluid (CSF) pathway by tumor mass. The procedure involves insertion of a drainage system into the brain to remove or drain excess of blocked fluid into the peritoneal cavity.

Stereotactic surgery: This surgery is done by creating a three-dimensional image called stereotaxy using computers. It aims to find out the location and position of the tumor. In fact it can also be done to aid tumor removal, implant radiation pellets or for other treatments.

Embolization: It is a procedure used to reduce the amount of blood supply to a tumor by blocking the blood flow in the selected arteries. It is generally performed before the main surgery.

Endoscopy and endoscope assisted surgery: Endoscope is the tool which helps to closely visualize the tissue through small openings in difficult to reach areas. This tool can be used in various brain surgeries to precisely reach the target location without damaging the adjacent structures.

Adjuvant modalities to improve outcome: In addition to above mentioned surgeries, following surgeries may also be performed in relation to brain tumor treatment:

  • Laser surgery
  • Photodynamic laser surgery
  • Ultrasonic aspiration
  • Fluorescent-guided surgery
  • Electrophysiological monitoring

In case you have a concern or query you can always consult an expert & get answers to your questions!

2084 people found this helpful

Brain Tumor Surgery - Know The Common Types!

MCh Neurosurgery, MS - General Surgery, MBBS
Neurosurgeon, Guwahati
Brain Tumor Surgery - Know The Common Types!

Although surgery is considered to be the first step of treatment in any form of tumor but its feasibility depends upon the type, size and location of the tumor. It is not necessary that every kind of brain tumor might require surgery.

Indications of Brain Tumor Surgery

  • Diagnosis of the type of tumor by taking a sample of the tumor for laboratory examination
  • Complete resection of tumor
  • Removal of the tumor as much as possible to slow down its growth and improve the symptoms.
  • Remove the tumor in order to help other treatment
  • Provide direct access for other forms of treatment like chemotherapy, radiotherapy etc.
  • To relieve pressure caused by tumor on surrounding structures

Types of Brain Tumor Surgery

The different types of surgery that are performed in cases of brain tumor include the following:

1. Craniotomy: Craniotomy is the most commonly performed procedure to remove brain tumor along with a piece of bone. The removed bone is replaced and the tumor is sent for histopathology (biopsy). The surgery is performed using a high end microscope by any of the following techniques:

  • Extended bifrontal craniotomy
  • "Eyebrow" craniotomy (supra-orbital craniotomy)
  • "Keyhole" craniotomy (retro-sigmoid craniotomy)
  • Orbitozygomatic craniotomy
  • Translabyrinthine craniotomy

2. Shunt: A narrow piece of flexible tube with a pressure regulated valve in between is called a shunt. This is used to relieve the intracranial pressure caused by obstruction of the natural brain fluid (CSF) pathway by tumor mass. The procedure involves insertion of a drainage system into the brain to remove or drain excess of blocked fluid into the peritoneal cavity.

3. Stereotactic surgery: This surgery is done by creating a three-dimensional image called stereotaxy using computers. It aims to find out the location and position of the tumor. In fact it can also be done to aid tumor removal, implant radiation pellets or for other treatments.

4. Embolization: It is a procedure used to reduce the amount of blood supply to a tumor by blocking the blood flow in the selected arteries. It is generally performed before the main surgery.

Endoscopy and endoscope assisted surgery: Endoscope is the tool which helps to closely visualize the tissue through small openings in difficult to reach areas. This tool can be used in various brain surgeries to precisely reach the target location without damaging the adjacent structures.

Adjuvant modalities to improve outcome: In addition to above mentioned surgeries, following surgeries may also be performed in relation to brain tumor treatment:

  • Laser surgery
  • Photodynamic laser surgery
  • Ultrasonic aspiration
  • Fluorescent-guided surgery
  • Electrophysiological monitoring. If you wish to discuss about any specific problem, you can consult a Neurosurgeon.
3026 people found this helpful

Brain Tumor Surgery

IFAANS, DNB (Neurosurgery), MBBS
Neurosurgeon, Ghaziabad
Brain Tumor Surgery

Although surgery is considered to be the first step of treatment in any form of tumor, but its feasibility depends upon the type, size and location of the tumor. It is not necessary that every kind of brain tumor might require surgery.

Indications of Brain Tumor Surgery

  • Diagnosis of the type of tumor by taking a sample of the tumor for laboratory examination
  • Complete resection of tumor
  • Removal of the tumor as much as possible to slow down its growth and improve the symptoms
  • Remove the tumor in order to help other treatment
  • Provide direct access for other forms of treatment like chemotherapy, radiotherapy etc.
  • To relieve pressure caused by tumor on surrounding structures

Types of Brain Tumor Surgery: The different types of surgery that are performed in cases of brain tumor include the following:

Craniotomy: Craniotomy is the most commonly performed procedure to remove brain tumor along with a piece of bone. The removed bone is replaced and the tumor is sent for histopathology (biopsy). The surgery is performed using a high end microscope by any of the following techniques:

  • Extended bifrontal craniotomy
  • "Eyebrow" craniotomy (supraorbital craniotomy)
  • "Keyhole" craniotomy (retro-sigmoid craniotomy)
  • Orbitozygomatic craniotomy
  • Translabyrinthine craniotomy

Shunt: A narrow piece of flexible tube with a pressure regulated valve in between is called a shunt. This is used to relieve the intracranial pressure caused by obstruction of the natural brain fluid, Cerebrospinal fluid (CSF) pathway by tumor mass. The procedure involves insertion of a drainage system into the brain to remove or drain excess of blocked fluid into the peritoneal cavity.

Stereotactic surgery: This surgery is done by creating a three dimensional image called stereotaxy using computers. It aims to find out the location and position of the tumor. In fact it can also be done to aid tumor removal, implant radiation pellets or for other treatments.

Embolization: It is a procedure used to reduce the amount of blood supply to a tumor by blocking the blood flow in the selected arteries. It is generally performed before the main surgery.

Endoscopy and endoscope assisted surgery: Endoscope is a tool, which helps to closely visualize the tissue through small openings in difficult to reach areas. This tool can be used in various brain surgeries to precisely reach the target location without damaging the adjacent structures.

Adjuvant modalities to improve outcome: In addition to above mentioned surgeries, following surgeries may also be performed in relation to brain tumor treatment:

  • Laser surgery
  • Photodynamic laser surgery
  • Ultrasonic aspiration
  • Fluorescence guided surgery (FGS)
  • Electrophysiological monitoring
4265 people found this helpful

Purpose and Types of Brain Tumor Surgery

MCh - Neurosurgery, MBBS
Neurosurgeon, Chennai
Purpose and Types of Brain Tumor Surgery

Although surgery is considered to be the first step of treatment in any form of tumor but its feasibility depends upon the type, size and location of the tumor. It is not necessary that every kind of brain tumor might require surgery.

Indications of Brain Tumor Surgery

  • Diagnosis of the type of tumor by taking a sample of the tumor for laboratory examination
  • Complete resection of tumor
  • Removal of the tumor as much as possible to slow down its growth and improve the symptoms.
  • Remove the tumor in order to help other treatment
  • Provide direct access for other forms of treatment like chemotherapy, radiotherapy etc.
  • To relieve pressure caused by tumor on surrounding structures

Types of Brain Tumor Surgery

The different types of surgery that are performed in cases of brain tumor include the following:

Craniotomy: Craniotomy is the most commonly performed procedure to remove brain tumor along with a piece of bone. The removed bone is replaced and the tumor is sent for histopathology (biopsy). The surgery is performed using a high end microscope by any of the following techniques:

  • Extended bifrontal craniotomy
  • "Eyebrow" craniotomy (supra-orbital craniotomy)
  • "Keyhole" craniotomy (retro-sigmoid craniotomy)
  • Orbitozygomatic craniotomy
  • Translabyrinthine craniotomy

Shunt: A narrow piece of flexible tube with a pressure regulated valve in between is called a shunt. This is used to relieve the intracranial pressure caused by obstruction of the natural brain fluid (CSF) pathway by tumor mass. The procedure involves insertion of a drainage system into the brain to remove or drain excess of blocked fluid into the peritoneal cavity.

Stereotactic surgery: This surgery is done by creating a three-dimensional image called stereotaxy using computers. It aims to find out the location and position of the tumor. In fact it can also be done to aid tumor removal, implant radiation pellets or for other treatments.

Embolization: It is a procedure used to reduce the amount of blood supply to a tumor by blocking the blood flow in the selected arteries. It is generally performed before the main surgery.

Endoscopy and endoscope assisted surgery: Endoscope is the tool which helps to closely visualize the tissue through small openings in difficult to reach areas. This tool can be used in various brain surgeries to precisely reach the target location without damaging the adjacent structures.

Adjuvant modalities to improve outcome: In addition to above mentioned surgeries, following surgeries may also be performed in relation to brain tumor treatment:

  • Laser surgery
  • Photodynamic laser surgery
  • Ultrasonic aspiration
  • Fluorescent-guided surgery
  • Electrophysiological monitoring 

    If you wish to discuss about any specific problem, you can consult a neurosurgeon.

3223 people found this helpful
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