Presentation
CLINICAL PRESENTATION Most patients with fibrothorax present with dyspnea on exertion. [accesssurgery.mhmedical.com]
Clinical Presentation Listen The most frequent presentation is that of a patient with recurrent or persistent pleural effusion. [thoracickey.com]
Eur Respir Mon; 2002: 22: 270–278 You must login to share this Presentation/Article on Twitter, Facebook, LinkedIn or by email. Member's Comments No comment yet. You must Login to comment this presentation. [ers-education.org]
Case presentation Case 1 A 46-year-old Chinese man, admitted to our hospital in March 2016, presented with progressive dyspnoea and right chest pain of 2 months duration. [jtd.amegroups.com]
A thorough understanding of the process gives one better knowledge as to their different aetiologies, presentations and prognoses. The nature of prevention of this meance varies in these types. [pubmed.ncbi.nlm.nih.gov]
Entire Body System
- Falling
She did not have any symptoms before the fall. Before the advent of anti-tubercular drugs, inducing pneumothorax to collapse the affected lung was one of the modalities for the treatment of pulmonary tuberculosis. [imagejournals.org]
There were no new falls or trauma. Initial vital signs in ED showed blood pressure 87/53 mmHg, heart rate of 72 beats per minute, respiratory rate 18 breaths per minute, oxygen saturation 99% of 2L nasal cannula. [asploro.com]
- Amyloidosis
Delay in treatment causes various complications like empyema necessitatis, septicemia, brain abscess, amyloidosis, bronchiectasis, fibrothorax, respiratory failure and death. [medical-dictionary.thefreedictionary.com]
- Goiter
[…] kidney fibrous capsule of liver fibrous capsule of spleen fibrous capsule of thyroid gland fibrous cavernitis fibrous coagulum Fibrous connective tissue fibrous cortical defect fibrous degeneration fibrous dysplasia fibrous dysplasia of bone fibrous goiter [medical-dictionary.thefreedictionary.com]
Respiratoric
- Pleural Disorder
In the case of hemothorax, control of coagulation disorders must be addressed before extensive surgery. [thoracickey.com]
Musculoskeletal
- Ankylosis
[…] fibrous ankylosis fibrous ankylosis fibrous appendix of liver fibrous articular capsule Fibrous Asbestos Cement fibrous astrocyte fibrous astrocyte fibrous bacterial viruses fibrous band of Champenois ▼ [medical-dictionary.thefreedictionary.com]
- Myopathy
[…] fibrotic myopathy fibrotic myopathy fibrotic ophthalmoplegia fibrotuberculosis fibrous fibrous fibrous fibrous fibrous adamantinoma fibrous adhesion fibrous ankylosis fibrous ankylosis fibrous ankylosis fibrous appendix of liver fibrous articular capsule [medical-dictionary.thefreedictionary.com]
Workup
A patient who appears septic is most likely suffering from empyema and needs an expedited workup. On physical exam, one may appreciate limited excursion on the affected hemithorax, decreased breath sounds, and dullness to percussion. [accesssurgery.mhmedical.com]
X-Ray
- Atelectasis
CT scan may be required to establish the degree of under development and to differentiate hypoplasia from other conditions that may closely mimic it radiographically: atelectasis from other causes, severe bronchiectasis with collapse and advanced fibrothorax [medical-dictionary.thefreedictionary.com]
A computed tomography scan revealed a persistent, small, loculated right pleural effusion; pleural thickening; and atelectasis of the right middle and lower lobes. Pulmonary function tests showed a severe restrictive defect. [hindawi.com]
Follow-up CT scans obtained at mediastinal (C) and lung (D) window settings after 13 months show more extensive pleural thickening, calcifications, increased lung opacity, and atelectasis with bronchiectasis in adjacent lung parenchyma. [ajronline.org]
Fluid in the pleural space also results in pulmonary compression and, if sufficient in quantity, atelectasis. The compressed atelectatic lung is trapped by inflammatory tissue coating the visceral pleura. [thoracickey.com]
Fig-3: Chest x-ray performed in emergency department eleven days following initial trauma, demonstrating moderate to large volume right-sided effusion with consolidation pneumonitis atelectasis. Interval worsening compared to prior study. [asploro.com]
Treatment
2005 - Sarcoidosis: update on extrathoracic organ problems Year: 2005 Croup: diagnosis and treatment Source: ISSN=ISSN 1810-6838, ISBN=, page=332 Year: 2006 Prevalence of asthma symptoms, diagnosis and treatment use in Romania Source: Annual Congress [ers-education.org]
This unique feature of calcific pleural effusion/fibrothorax may be seen as a sequalea in patients who had induced pneumothorax for treatment of tuberculosis [imagejournals.org]
Treatment and prognosis Treatment options can range from conservative to surgical intervention with pleural decortication considered in selected cases 5. References Promoted articles (advertising) [radiopaedia.org]
[…] of fibro- thorax and iatrogenic pneumothorax complicating pulmonary tuberculosis.1,19,20,21,40,41,64,65,66 More than 50 years after its inception, decortication of the lung in the treatment of fibrothorax was finally established. [thoracickey.com]
Prognosis
Treatment and prognosis Treatment options can range from conservative to surgical intervention with pleural decortication considered in selected cases 5. References Promoted articles (advertising) [radiopaedia.org]
The prognosis after surgical decortication is variable and depends on the health of the underlying lung before the procedure takes place. [owlapps.net]
[…] tuberculosis, collagen vascular diseases, uraemia, rheumatoid arthritis, pleurodesis, pleural effusion, certain medications Risk factors Asbestos exposure, certain drugs Diagnostic method Chest X-ray, CT scan Treatment Watchful waiting, decortication Prognosis [en.wikipedia.org]
Etiology
Fibrothorax is a complication of many etiologies including pleural effusion or undrained hemothorax, infections such as empyema or tuberculosis, sometimes iatrogenic secondary to therapeutic pleurodesis or by exposure to certain substances such as asbestos [omicsonline.org]
Content[edit | edit source] 1Etiology and pathogenesis 2Clinical picture 3Therapy 4Links 4.1related articles 4.2References Etiology and pathogenesis[edit | edit source] Untreated pleural effusion, hemothorax, TB, silicosis, asbestosis. [wikilectures.eu]
Diffuse diseases may be inflammatory or infectious in etiology as in fibrothorax, or neoplastic (Figure 11), either primary or metastatic. [medical-dictionary.thefreedictionary.com]
Depending on the underlying etiology and the degree of parenchymal involvement, symptoms may vary. Exertional dyspnea is the most common symptom, usually reported as progressive over a long period of time. [thoracickey.com]
[…] increased awareness of normal breathing such as during an anxiety attack, (2) an increase in the work of breathing and (3) an abnormality in the ventilatory or respiratory system.[11] The tempo of onset and the duration of dyspnea are useful in knowing the etiology [en.wikipedia.org]
Epidemiology
[…] treatment Source: Annual Congress 2008 - PG4 - Paediatric respiratory medicine: wheezing children: asthma and beyond Year: 2008 Unusual diagnosis of exercise induced dyspnea Source: Annual Congress 2013 –Paediatric bronchology Year: 2013 Diagnosis, epidemiology [ers-education.org]
Epidemiology Sporadic cases are rarely reported in the medical literature, for example, due to iatrogenic or postoperative complications. Fibrothorax is rare in developed countries, mainly due to a lower incidence of tuberculosis. [owlapps.net]
Other factors predicting poorer surgical outcomes include intraoperative complications, incomplete surgery, lung disease beyond the fibrothorax being treated, and specific causes of fibrothorax such as asbestosis.[10] Epidemiology[edit] Sporadic cases [en.wikipedia.org]
Pathophysiology
The term decortication was first coined by the French surgeon Delorme in 1894.1 PATHOPHYSIOLOGY OF FIBROTHORAX The most common cause of fibrothorax is a parapneumonic effusion that was incompletely drained or never drained. [accesssurgery.mhmedical.com]
[…] space.2,10,24,27,47,55,58 Despite earlier diagnosis and minimally invasive abilities to drain the pleural space, entrapment of the lung still occurs.59 Once organization has occurred, thoracotomy and decortication remain the treatment of choice.8,61 Pathophysiology [thoracickey.com]
October 2010.[13] The most common cardiovascular causes are acute myocardial infarction and congestive heart failure while common pulmonary causes include chronic obstructive pulmonary disease, asthma, pneumothorax, pulmonary edema and pneumonia.[2] On a pathophysiological [en.wikipedia.org]
Prevention
The nature of prevention of this meance varies in these types. [pubmed.ncbi.nlm.nih.gov]
Timely evacuation of hemothorax, empyema, or large pleural effusions with expansion of the underlying lung is critical in the prevention of fibrothorax. [thoracickey.com]
29613-0_130 3 Mentions 339 Downloads Synonyms Definition Fibrothorax is a condition characterized by accumulation of fibrous tissue in the pleural cavity in reaction to undrained pleural fluid, where a thick “peel” can form on either pleural surface, preventing [link.springer.com]