Author, Donkey, Bureaucrats, Administrators
53,803
edits
Changes
→Diagnosis
Exudates may occur in any of the major body cavities. In the '''abdomen''', there may be signs of abdominal pain (due to the underlying cause of the effusion), an abdominal fluid thrill or a palpable mass.<br>
Exudates may occur in any of the major body cavities. In the '''abdomen''', there may be signs of abdominal pain (due to the underlying cause of the effusion), an abdominal fluid thrill or a palpable mass.<br>
In the '''chest''', a pleural effusion (including pyothorax) may cause tachypnoea and dyspnoea if severe. Dullness will be evident on thoracic percussion if a pleural effusion has developed and the heart sounds will be muffled on auscultation.<br>
In the '''chest''', a pleural effusion (including pyothorax) may cause tachypnoea and dyspnoea if severe. Dullness will be evident on thoracic percussion if a pleural effusion has developed and the heart sounds will be muffled on auscultation.<br>
'''Pericardial effusions''' may be sufficiently severe to cause '''cardiac tamponade''' and right-sided heart failure. The heart sounds will be muffled on auscultation and there may be hepatojugular reflux, a jugular pulse or signs of left-sided forward failure. The exudate of a chronic septic pericarditis undergoes organisation and replacement with fibrous tissue which bridges the visceral and parietal pericardia. This results in a '''restrictive pericarditis''' with clinical signs similar to cardiac tamponade. Infections which penetrate deeply into the cardiac muscle may cause '''myocarditis''' with disruptions of the normal conduction pathways and resultant dysryhthmias.<br>
'''Pericardial effusions''' may be sufficiently severe to cause '''[[Cardiac Tamponade|cardiac tamponade]]''' and right-sided [[Hear Failure|heart failure]]. The heart sounds will be muffled on auscultation and there may be hepatojugular reflux, a jugular pulse or signs of left-sided forward failure. The exudate of a chronic septic pericarditis undergoes organisation and replacement with fibrous tissue which bridges the visceral and parietal pericardia. This results in a '''restrictive pericarditis''' with clinical signs similar to cardiac tamponade. Infections which penetrate deeply into the cardiac muscle may cause '''[[Myocarditis|myocarditis]]''' with disruptions of the normal conduction pathways and resultant dysryhthmias.<br>
Septic processes may be accompanied by more general signs of infection, including '''pyrexia''', depression, lethargy and anorexia. Highly inflammatory exudates may cause severe pain when they damage the parietal pleura or peritoneum. Affected animals may be reluctant to walk and will stand with a typical 'tucked-up' posture.
Septic processes may be accompanied by more general signs of infection, including '''pyrexia''', depression, lethargy and anorexia. Highly inflammatory exudates may cause severe pain when they damage the parietal pleura or peritoneum. Affected animals may be reluctant to walk and will stand with a typical 'tucked-up' posture.
===Diagnostic Imaging===
===Diagnostic Imaging===
Effusions are easily diagnosed by '''ultrasonography''' and this modality may also be used to guide fine needle aspiration to obtain a sample of the fluid. Effusions also produce a distinctive pattern on '''plain radiograph'''s:
Effusions are easily diagnosed by '''ultrasonography''' and this modality may also be used to guide fine needle aspiration to obtain a sample of the fluid. Effusions also produce a distinctive pattern on '''plain radiographs''':
With '''pericardial effusion''', the heart may appear to be generally enlarged with a globular shape. There may be a crisp cardiac silhouette (as the heart is moving within a stationary bag of fluid) and a hypovascular lung pattern due to pulmonary underperfusion.
With '''ascites''', there is a loss of serosal detail due to the presence of fluid in the abdominal cavity. This appearance may also occur with large abdominal masses and in emaciated animals. Pneumoperitoneum may occur if the gut has ruptured or, in the case of pancreatitis, there may be an area of localised peritonitis (resembling 'ground glass') in the cranial abdomen.
With '''pleural effusions''', the lung lobes are contracted and lobulation is evident. Areas of peripheral radio-opacity should be evident, especially peripherally in the chest.
'''Pyothorax''' may be diagnosed and treated by '''thoracoscopy''', the passage of an endoscope into the pleural space. This technique is especially useful in the detection of loculation, the formation of septa of fibrous tissue that divided the effusion into pockets of fluid.
===Cytology===
===Cytology===
|}
|}
With a septic exudate, the neutrophils that are present are more likely to be present and intracellular (phagocytosed) bacteria may be visible.
With a septic exudate, the neutrophils are more likely to be present and intracellular (phagocytosed) bacteria may be visible.
In '''horses''', enterocentesis (or paracentesis) is often performed as part of a colic work-up. The following findings are considered to be abnormal and may lend support to a decision to manage the case surgically:
In '''horses''', enterocentesis (or paracentesis) is often performed as part of a [[Colic Diagnosis - Abdominocentesis|colic work-up]]. The following findings are considered to be abnormal and may lend support to a decision to manage the case surgically:
{| cellpadding="10" cellspacing="0" border="1"
{| cellpadding="10" cellspacing="0" border="1"
| Appearance
| Appearance