Difference between revisions of "Category:Effusions"

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(Created page with '==Effusions== *Increased amount of fluid in peritoneal, pleural or pericardial cavity *Not a disease in itself *Indicates pathologic…')
 
 
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==Effusions==
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|pagetitle =Effusions
*Increased amount of fluid in [[Peritoneal cavity - Anatomy & Physiology|peritoneal]], pleural or pericardial cavity
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*Not a disease in itself
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'''Effusions''' are increased amounts of fluid in the [[Peritoneal Cavity - Anatomy & Physiology|peritoneal]], pleural or pericardial cavities. They are not diseases in themselves but they indicate the presence of a pathological process which has altered the local balance of fluid production and removal.
*Indicates pathological process affecting fluid production and/or removal
 
 
 
*Classification
 
**Based on cell counts and total protein
 
***Transudate
 
***Modified transudate
 
***Exudate
 
**Haemorrhage
 
**Chylous effusion
 
 
 
*Transudate and modified transudate are usually present in the clinical sign '''"ascites"'''
 
 
 
 
 
 
 
 
 
 
 
===[[Transudate]]===
 
 
 
 
 
 
 
===Modified transudate===
 
 
 
*'''High cells''' and '''low protein''' OR '''Low cells''' and '''high protein'''
 
*Yellow to serosanguinous, turbid
 
*Specific gravity 1.018 - 1.030
 
*Total protein 25 - 50g/L
 
*Nucleated cells 0.3 - 5.5 x10e9/L (up to 7 x 10e9/L)
 
*[[Mesothelial cells|Mesothelial cells]], [[Macrophages - WikiBlood|macrophages]], non-degenerate neutrophils, small [[Lymphocytes - WikiBlood|lymphocytes]]
 
 
 
*'''Due to:'''
 
**Cardiac disease
 
***Increased hydrostatic pressure within blood vessels
 
***May be compounded by hypertension
 
**Chylous effusions (see below)
 
**Lymphatic obstruction (neoplasia - e.g. papillary adenocarcinoma of the ovary in the bitch, also produces fluid)
 
 
 
 
 
===Exudate===
 
 
 
*'''High cells''' and '''high protein'''
 
*Turbid - red, yellow, white
 
*Specific gravity > 1.018
 
*Total protein > 30g/L
 
*Nucleated cells >3 x 10e9/L
 
*[[Neutrophils - WikiBlood|Neutrophils]] non-degenerate or degenerate, [[Macrophages - WikiBlood|macrophages]], [[Lymphocytes - WikiBlood|lymphocytes]], [[Eosinophils - WikiBlood|eosinophils]] (with parasites)
 
 
 
*'''Due to:'''
 
**Inflammation of the pleural/abdominal cavities or their lining
 
***Septic
 
****Degenerate neutrophils
 
****Intracellular bacteria
 
****''In horses''
 
*****Yellow, brown turbid
 
*****Look for plant material - rupture or [[Enterocentesis|perforation]] of gut wall
 
*****Horses with gut rupture will quickly develop cardiovascular collapse
 
***Non-septic
 
****Non-derenerate neutrophils
 
****No bacteria
 
****''In horses''
 
*****Amber, slightly turbid fluid
 
*****[[Neutrophils - WikiBlood|Neutrophils]] > [[Macrophages - WikiBlood|macrophages]]
 
****e.g.[[Feline Infectious Peritonitis|FIP]]
 
**Long standing modified transudate becomes exudate
 
**Neoplasia (cell numbers really high)
 
 
 
 
 
 
 
===Haemorrhage===
 
 
 
*Turbid - red
 
*Specific gravity 1.025 - 1.040
 
*Total protein > 30g/L
 
*Nucleated cells 1.5 - 10 x 10e9/L
 
*WBC from peripheral blood (including [[Neutrophils - WikiBlood|neutrophils]] and [[Macrophages - WikiBlood|macrophages]])
 
 
 
*Recent or iatrogenic
 
**Erythrocytes
 
**Platelet clumps
 
*Long standing haemorrage
 
**Macrophages with erythrophagia of haeme pigment
 
*''In horses'' in addition to the above
 
**Haemorrhagic diapedesis
 
***Leakage of blood and fluid from the gut secondary to compromised vascular supply and venous return
 
***Seen with interstitial necrosis/ischaemia
 
***Fluid appears serosanguinous
 
 
 
'''Due to'''
 
*Most commonly seen in cats and dogs due to traumatic injury to the [[Liver - Anatomy & Physiology|liver]] (e.g. [[Infectious Canine Hepatitis|infectious canine hepatitis]]), spleen (e.g. '''haemangiosarcoma''') and kidney
 
*Warfarin toxicity
 
*Moldy sweet clover hay fed to pregnant cows may bleed from umbilical vessels into [[Peritoneal cavity - Anatomy & Physiology|peritoneum]]
 
*Manual ablation of [[Corpus Luteum|corpus luteum]] in cattle
 
 
 
===Chylous effusion===
 
 
 
*Opaque, milky
 
*Specific gravity > 1.017
 
*Total protein > 30g/L (variable)
 
*Nucleated cells 1.5 - 20 x 10e9/L
 
*Small [[Lymphocytes - WikiBlood|lymphocytes]], mature [[Neutrophils - WikiBlood|neutrophils]], variable [[Macrophages - WikiBlood|macrophages]])
 
 
 
*Chyle
 
**Triglycerides in fluid > in serum
 
**Cholesterol in fluid < in serum
 
**Formation of "cream top" (chylomicrons) if refrigerated
 
**Does not deparate on centrifugation
 
**Sudan III staining lipid droplets
 
 
 
==Ectopic sources of fluid==
 
 
 
*'''Urine'''
 
**Uroabdomen
 
**Transudate or modified transudate
 
 
 
*'''Bile'''
 
**[[Peritoneal Cavity Inflammatory - Pathology#Causes of peritonitis|Bile peritonitis]]
 
**Green in colour
 
**Modified transudate or exudate
 
 
 
*[[Pancreas - Inflammatory Pathology|'''Pancreatitis''']]
 
**Modified transudate or exudate
 
 
 
 
 
  
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The classification of effusions is based on the '''total cell count''' and '''total protein content''' of the fluid:
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*[[Transudate|'''Transudates''']] and [[Modified Transudate|'''modified transudates''']] have the lowest protein contents and cell counts.  They usually result from imbalances in the [[Blood Pressure Physiology#Capillary Fluid Shift Mechanism |Starling forces]].
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*[[Exudate|'''Exudates''']] have the highest cell counts and protein contents and usually occur with an inflammatory or neoplastic disease process.
  
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Effusions may also occur when other fluids leak into the abdominal or thoracic cavities.  Fluids that may be involved include:
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*'''Urine''', producing a '''uroabdomen''' (a [[Modified Transudate|modified transudate]] or [[Exudate|exudate]]).
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*'''Bile''', producing [[Peritonitis#Causes of peritonitis|'''bile peritonitis''']] (a [[Modified Transudate|modified transudate]] or [[Exudate|exudate]])).
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*'''Pancreatic juices''' leaking in [[Pancreas - Inflammatory Pathology|'''pancreatitis''']] (producing a [[Modified Transudate|modified transudate]] or [[Exudate|exudate]]).
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*'''Blood''', producing a '''[[Haemoabdomen|haemoabdomen]]''' (a [[Haemorrhagic Effusion|haemorrhagic effusion]]).
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*'''Chyle''' (or lymph), producing a [[Chylous Effusion|chylous effusion]] in the thorax or abdomen.
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*'''Pseudochyle''', a mixture of cellular debris and lipid that may resemble a [[Chylous Effusion|chylous effusion]].
  
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[[Category:Peritoneal Cavity - Pathology]]
 
[[Category:Peritoneal Cavity - Pathology]]

Latest revision as of 18:43, 15 February 2011

Effusions

Effusions are increased amounts of fluid in the peritoneal, pleural or pericardial cavities. They are not diseases in themselves but they indicate the presence of a pathological process which has altered the local balance of fluid production and removal.

The classification of effusions is based on the total cell count and total protein content of the fluid:

  • Transudates and modified transudates have the lowest protein contents and cell counts. They usually result from imbalances in the Starling forces.
  • Exudates have the highest cell counts and protein contents and usually occur with an inflammatory or neoplastic disease process.

Effusions may also occur when other fluids leak into the abdominal or thoracic cavities. Fluids that may be involved include:

Pages in category "Effusions"

The following 5 pages are in this category, out of 5 total.