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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
| + | '''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
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| − | *Classification
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| − | **Based on cell counts and total protein
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| − | ***Transudate
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| − | ***Modified transudate
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| − | ***Exudate
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| − | **Haemorrhage
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| − | **Chylous effusion
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| − | *Transudate and modified transudate are usually present in the clinical sign '''"ascites"'''
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| − | ===[[Transudate]]=== | |
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| − | ===Modified transudate===
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| − | *'''High cells''' and '''low protein''' OR '''Low cells''' and '''high protein'''
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| − | *Yellow to serosanguinous, turbid
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| − | *Specific gravity 1.018 - 1.030
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| − | *Total protein 25 - 50g/L
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| − | *Nucleated cells 0.3 - 5.5 x10e9/L (up to 7 x 10e9/L)
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| − | *[[Mesothelial cells|Mesothelial cells]], [[Macrophages - WikiBlood|macrophages]], non-degenerate neutrophils, small [[Lymphocytes - WikiBlood|lymphocytes]]
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| − | *'''Due to:'''
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| − | **Cardiac disease
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| − | ***Increased hydrostatic pressure within blood vessels
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| − | ***May be compounded by hypertension
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| − | **Chylous effusions (see below)
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| − | **Lymphatic obstruction (neoplasia - e.g. papillary adenocarcinoma of the ovary in the bitch, also produces fluid)
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| − | ===Exudate===
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| − | *'''High cells''' and '''high protein'''
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| − | *Turbid - red, yellow, white
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| − | *Specific gravity > 1.018
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| − | *Total protein > 30g/L
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| − | *Nucleated cells >3 x 10e9/L
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| − | *[[Neutrophils - WikiBlood|Neutrophils]] non-degenerate or degenerate, [[Macrophages - WikiBlood|macrophages]], [[Lymphocytes - WikiBlood|lymphocytes]], [[Eosinophils - WikiBlood|eosinophils]] (with parasites)
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| − | *'''Due to:'''
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| − | **Inflammation of the pleural/abdominal cavities or their lining
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| − | ***Septic
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| − | ****Degenerate neutrophils
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| − | ****Intracellular bacteria
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| − | ****''In horses''
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| − | *****Yellow, brown turbid
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| − | *****Look for plant material - rupture or [[Enterocentesis|perforation]] of gut wall
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| − | *****Horses with gut rupture will quickly develop cardiovascular collapse
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| − | ***Non-septic
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| − | ****Non-derenerate neutrophils
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| − | ****No bacteria
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| − | ****''In horses''
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| − | *****Amber, slightly turbid fluid
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| − | *****[[Neutrophils - WikiBlood|Neutrophils]] > [[Macrophages - WikiBlood|macrophages]]
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| − | ****e.g.[[Feline Infectious Peritonitis|FIP]]
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| − | **Long standing modified transudate becomes exudate
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| − | **Neoplasia (cell numbers really high)
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| − | ===Haemorrhage===
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| − | *Turbid - red
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| − | *Specific gravity 1.025 - 1.040
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| − | *Total protein > 30g/L
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| − | *Nucleated cells 1.5 - 10 x 10e9/L
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| − | *WBC from peripheral blood (including [[Neutrophils - WikiBlood|neutrophils]] and [[Macrophages - WikiBlood|macrophages]])
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| − | *Recent or iatrogenic
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| − | **Erythrocytes
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| − | **Platelet clumps
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| − | *Long standing haemorrage
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| − | **Macrophages with erythrophagia of haeme pigment
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| − | *''In horses'' in addition to the above
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| − | **Haemorrhagic diapedesis
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| − | ***Leakage of blood and fluid from the gut secondary to compromised vascular supply and venous return
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| − | ***Seen with interstitial necrosis/ischaemia
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| − | ***Fluid appears serosanguinous
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| − | '''Due to'''
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| − | *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
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| − | *Warfarin toxicity
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| − | *Moldy sweet clover hay fed to pregnant cows may bleed from umbilical vessels into [[Peritoneal cavity - Anatomy & Physiology|peritoneum]]
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| − | *Manual ablation of [[Corpus Luteum|corpus luteum]] in cattle
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| − | ===Chylous effusion===
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| − | *Opaque, milky
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| − | *Specific gravity > 1.017
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| − | *Total protein > 30g/L (variable)
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| − | *Nucleated cells 1.5 - 20 x 10e9/L
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| − | *Small [[Lymphocytes - WikiBlood|lymphocytes]], mature [[Neutrophils - WikiBlood|neutrophils]], variable [[Macrophages - WikiBlood|macrophages]])
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| − | *Chyle
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| − | **Triglycerides in fluid > in serum
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| − | **Cholesterol in fluid < in serum
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| − | **Formation of "cream top" (chylomicrons) if refrigerated
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| − | **Does not deparate on centrifugation
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| − | **Sudan III staining lipid droplets
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| − | ==Ectopic sources of fluid==
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| − | *'''Urine'''
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| − | **Uroabdomen
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| − | **Transudate or modified transudate
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| − | *'''Bile'''
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| − | **[[Peritoneal Cavity Inflammatory - Pathology#Causes of peritonitis|Bile peritonitis]]
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| − | **Green in colour
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| − | **Modified transudate or exudate
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| − | *[[Pancreas - Inflammatory Pathology|'''Pancreatitis''']]
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| − | **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: |
| | + | *[[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]]. |
| | + | *[[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: |
| | + | *'''Urine''', producing a '''uroabdomen''' (a [[Modified Transudate|modified transudate]] or [[Exudate|exudate]]). |
| | + | *'''Bile''', producing [[Peritonitis#Causes of peritonitis|'''bile peritonitis''']] (a [[Modified Transudate|modified transudate]] or [[Exudate|exudate]])). |
| | + | *'''Pancreatic juices''' leaking in [[Pancreas - Inflammatory Pathology|'''pancreatitis''']] (producing a [[Modified Transudate|modified transudate]] or [[Exudate|exudate]]). |
| | + | *'''Blood''', producing a '''[[Haemoabdomen|haemoabdomen]]''' (a [[Haemorrhagic Effusion|haemorrhagic effusion]]). |
| | + | *'''Chyle''' (or lymph), producing a [[Chylous Effusion|chylous effusion]] in the thorax or abdomen. |
| | + | *'''Pseudochyle''', a mixture of cellular debris and lipid that may resemble a [[Chylous Effusion|chylous effusion]]. |
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| | + | </div> |
| | + | |contenttitle =Content |
| | + | |contentbody =<big><b> |
| | + | <categorytree mode=pages>Effusions</categorytree> |
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| | + | </b></big> |
| | + | | logo =path-logo.png |
| | + | }} |
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| | [[Category:Peritoneal Cavity - Pathology]] | | [[Category:Peritoneal Cavity - Pathology]] |