ABC of Pleural Diseases (eBook)

Najib M. Rahman, Ian Hunt, Fergus V. Gleeson, Nick A. Maskell (Herausgeber)

eBook Download: PDF

2018
John Wiley & Sons (Verlag)
978-1-118-52711-5 (ISBN)

Infos

Pleural diseases are frequently managed in primary care, but specialist knowledge is required to understand the full variety of presentations and available treatments in this rapidly developing field. ABC of Pleural Diseases is a brand new addition to the ABC Series which takes a unique approach to these conditions by dealing with them as a related group as well as in their individual manifestations.

The book provides a unique and comprehensive overview of pleural disease, beginning with the anatomy and physiology of the pleura. It then covers a wide range of specific conditions in greater detail, including pneumothorax, pleural effusions, pleural infections, as well as chapters on radiology and pathology. Full coverage is given of mesothelioma, the most common pleural cancer.

Written by a team of specialists, this reference guide to pleural diseases is a practical guide for General Practitioners, Junior Doctors, Specialist Nurses, Radiologists and all Healthcare Professionals working within chest medicine.

Najib M. Rahman, Associate Professor of Respiratory Medicine, Nuffield Department of Medicine and Clinical Director, Oxford Respiratory Trials Unit, University of Oxford, Oxford, UK.

Ian Hunt, Consultant Thoracic Surgeon at St George's Hospital, Honorary Consultant at the Royal Marsden Hospital, Honorary Senior Lecturer at St George's, University of London, London, UK.

Fergus V. Gleeson, Consultant Radiologist and Professor of Radiology, University of Oxford; Director of the Oxford Imaging Trials Unit, and Divisional Director for the Oxford University Hospitals NHS Trust, London, UK.

Nick A. Maskell, Professor of Respiratory Medicine, School of Clinical Sciences, University of Bristol, Bristol, UK.

Inhalt

Title Page 5
Copyright Page 6
Contents 7
Contributors 9
Chapter 1 Anatomy and Physiology of the Pleura 11
Embryology 11
Macroscopic anatomy 11
Microscopic anatomy 12
Mesothelial cells 12
Innervation, blood supply and lymphatics 12
Innervation 12
Blood supply 12
Lymphatics 12
Physiology of the pleural space 13
Pleural pressure 13
Pleural fluid formation and constituents 13
Pleural fluid absorption 13
Role of the pleural space 13
Further reading 13
Chapter 2 Radiology of Pleural Disease 15
Plain radiography 15
Ultrasound 15
CT scan 17
PET CT 17
MRI 18
Further reading 18
Chapter 3 Pneumothorax 19
Definition, epidemiology, risk factors and aetiology 19
Presentation 19
Investigations 19
Management 20
Tension (i.e. haemodynamically unstable) pneumothoraces 21
Haemodynamically stable 21
Conservative management 21
Needle aspiration 21
Chest drains 21
Heimlich valves 22
Digital thoracic drainage 22
Referral of patients 22
Recurrent pneumothorax 22
Further reading 22
Chapter 4 Investigation of Pleural Effusions 23
Clinical presentation 23
History taking 23
Examination 23
Initial imaging 24
Chest X-ray 24
Thoracic ultrasound 25
Pleural fluid tests 25
Fluid appearance 26
Distinguishing exudates and transudates 26
Pleural fluid cytology and differential cell counts 26
Microscopy and culture 26
Pleural fluid pH (and glucose) 27
Lipids 27
Biomarkers and auto-antibodies 27
Cross-sectional imaging 27
Metabolic and dynamic imaging 28
Pleural biopsy 29
Diagnostic challenges 29
Further reading 29
Chapter 5 Pleural Pathology 31
Normal anatomy and histology of the pleura 31
Pathological processes involving the pleura 31
Neoplasia (other than diffuse malignant mesothelioma) – primary pleural neoplasms and tumour-like proliferations 32
Benign 32
Tumour-like conditions 34
Malignant pleural neoplasms (other than malignant mesothelioma) 35
Inflammation 35
Further reading 37
Chapter 6 Unusual Causes of Pleural Disease 39
Urinothorax 39
Yellow nail syndrome 39
Ovarian hyperstimulation syndrome 39
Meigs syndrome 40
Dural-pleural fistula 41
Central venous catheter migration 41
Chylothorax 41
Pseudochylothorax 42
Further reading 42
Chapter 7 Pleural Infection 43
Pathology 43
Bacteriology 44
Natural history 44
Symptoms and signs 44
Diagnosis 44
Thoracic ultrasound scan 44
Pleural fluid aspiration 45
Further imaging 45
Medical management 45
Initial care 45
Antibiotics 45
Chest tube drainage 45
Fibrinolytics 45
Surgery 45
VATS debridement and decortication 46
Rib resection and drainage 46
Thoracotomy decortication 46
Open window thoracostomy 46
Thoracoplasty 46
Trapped lung 46
Prognosis and long?term outcomes 46
Conclusions 47
Further reading 47
Chapter 8 Management of Malignant Pleural Effusions 49
Pathophysiology 49
Symptoms 49
Management – general considerations 49
Simple pleural aspiration 50
Intercostal chest drainage and pleurodesis 50
Thoracoscopy and talc poudrage 51
Indwelling pleural catheters 52
Which procedure is best? 53
The future 53
Conclusions 54
Further reading 55
Chapter 9 Malignant Mesothelioma 57
Epidemiology and aetiology 57
Pathogenesis 57
Clinical presentation and investigation 58
Pathological features 58
Epithelioid malignant mesothelioma 58
Sarcomatoid malignant mesothelioma 60
Biphasic malignant mesothelioma 60
Well-differentiated papillary mesothelioma 60
Localised malignant mesothelioma 62
Diagnosis 62
Treatment and prognosis 62
Further reading 62
Chapter 10 Pleural Interventions: Section A: Pleural Aspiration 63
Diagnostic thoracocentesis 63
Step-by-step approach 63
Avoidance of the intercostal arteries 63
Therapeutic thoracocentesis 63
Step-by-step approach 63
Complications of diagnostic and therapeutic thoracocentesis 65
Further reading 65
Section B: Chest Drain Insertion 66
Chest drain insertion (Seldinger technique) 66
Pre-drain insertion 66
Drain insertion technique 67
Post drain insertion 68
Drain removal 68
Tips 69
Troubleshooting 69
Further reading 69
Section C: Insertion of an Indwelling Pleural Catheter 70
A step-by-step guide to IPC insertion 70
Chapter 11 Medical Thoracoscopy: Section A: Rigid Thoracoscopy 73
Role of medical thoracoscopy 73
Who should undergo a thoracoscopy? 73
Types of medical thoracoscopy 73
A step-by-step guide to medical thoracoscopy 74
Patient preparation and consent 74
Procedure 74
Other considerations 74
Post procedure care 76
Diagnostic accuracy of medical thoracoscopy 77
Complications and adverse events with medical thoracoscopy 77
Complications and adverse events: rigid thoracoscopy versus semi-rigid thoracoscopy 77
Conclusions 78
Further reading 78
Section B: Semi-Rigid Thoracoscopy 79
Role of medical thoracoscopy 79
A step-by-step guide to semi-rigid thoracoscopy 79
Advantages of the semi-rigid thoracoscope 80
Disadvantages of the semi-rigid thoracoscope 81
Diagnostic accuracy of semi-rigid thoracoscopy 81
Diagnostic accuracy: rigid thoracoscopy versus semi-rigid thoracoscopy 82
Complications and adverse events with semi-rigid thoracoscopy 82
Conclusions 82
Chapter 12 Surgical Management of Pleural Disease 83
Historical developments 83
Thoracic anaesthetic 83
Thoracic surgery 83
Primary and secondary pneumothoraces 84
Malignant pleural effusions 84
Empyema 84
Pleural tumour 84
Trauma 85
Conclusions 85
Further reading 85
Index 87
EULA 90

Produkt-Details

• Erscheint lt. Verlag: 20.2.2018
• Reihe/Serie: ABC Series
• Reihe/Serie: ABC Series
• Sprache: englisch
• Themenwelt: Medizinische Fachgebiete ► Innere Medizin ► Pneumologie
• Schlagworte: Allgemeine u. Innere Medizin • Chest • Chylothorax • empyemas • epidemiology • General & Internal Medicine • malignant effusions • medical education • Medical Science • Medizin • Medizin des Atmungssystems • Medizinstudium • mesothelioma • parapneumonic • Pleura • Pleural Disease • Pleural effusions • Pleural infections • Pneumothorax • Respiratory Medicine • Surgical management
• ISBN-10: 1-118-52711-9 / 1118527119
• ISBN-13: 978-1-118-52711-5 / 9781118527115