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Ventriculo Pleural Shunt Tips

Pleural Effusion - Most Effective Treatment Methods!

Dr. Mool Chand Gupta 91% (35709 ratings)
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

Dr. Deepak Arsikere Nataraju 89% (20 ratings)
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!

Dr. Hemant Kalra 87% (369 ratings)
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

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!

2707 people found this helpful

The Surgical Treatment For Portal Hypertension!

Dr. Siddharth Jain 91% (95 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!

2537 people found this helpful

Brain Tumor - Types Of Surgeries Available!

Dr. Anshul Gupta 90% (14 ratings)
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!

Dr. Shameem Ahmed 91% (150 ratings)
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

Dr. Manish Vaish 86% (77 ratings)
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

TB Symptoms - What Are The Signs Of Tuberculosis?

Dr. Mool Chand Gupta 91% (35709 ratings)
MD - Pulmonary, DTCD
Pulmonologist, Faridabad
TB Symptoms - What Are The Signs Of Tuberculosis?

Tuberculosis (TB) is one of most deadly diseases know globally. It is an infectious disease occurring in many developing and developed countries as well. However, more patients can be seen coming from developing nations. According to WHO (World Health Organisation), 9 million people suffer from TB in a year. Tuberculosis is one of the diseases leading to deaths among women aged between 15 to 40 years.

The main cause of TB is a bacterium called Mycobacterium tuberculosis. It is an infectious disease that is also contagious. However, tuberculosis can be of two varying types:

  1. Latent TB- In this case, the bacteria causing TB remains inactive in a person’s body and does not show any signs and symptoms of TB. However, it may become active. An estimated 2 million people have latent TB and need to be treated.
  2. Active TB- The bacteria causing TB is active and results in various symptoms which can be transmitted from one person to another.

Some of the signs and symptoms of active TB are:

  1. Severe Cough
  2. Coughing up Blood (Hemoptysis)
  3. Chest Pain
  4. Loss of Weight
  5. Fatigue
  6. Fever
  7. Night Sweats
  8. Decreased Appetite
  9. Feeling Cold
  10. Having Difficulty in Breathing
  11. Swollen Lymph Nodes

There are other types of TB occurring among people that have many more symptoms:

  1. Skeletal TB (Pott’s Disease)
  2. TB Meningitis- headaches, mental changes and coma
  3. TB Arthritis- usually pain in knees and joints
  4. Genitourinary TB- dysuria, flank pain, increased frequency, masses or lumps
  5. Gastrointestinal TB- problem in swallowing, ulcers, mal-absorption and diarrhoea
  6. Military TB- It is basically small nodules that occur in organs
  7. Pleural TB- This basically refers to the respiratory problems of empyema and pleural effusions
  8. Multidrug-resistant Tuberculosis (MDR TB)- People suffering from TB and having medications for it may develop a resistant to certain drugs over time.
  9. XDR TB- Patients being drug resistant to tuberculosis drugs. XDR stands for extensively drug-resistant.
  10. Caseous TB- Necrotic (dead and dying) tissue infected with TB has a dry and cheesy appearance.

These were some of the symptoms associated with various types of Tuberculosis. However, its diagnosis may range of doing a skin test to blood tests to x-rays to sputum tests. Along with this doctors use a stethoscope to listen to the sounds of lungs.

What you need to keep in mind is that TB affects other parts of the body as well. If you are having tuberculosis in your kidneys, then it results in loss of blood through urine. So you need to observant and report to your doctor accordingly.

As TB is a contagious disease, its treatments require certain medications which have to be consumed for a period of 6 months. For effective results and better recovery, doctors advise patients to complete the full course of medications.

4496 people found this helpful
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