Difference between revisions of "Chylothorax"

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'''Quick Start:''' ''You can begin to add to or edit text on this wiki doc page by clicking on the edit button above and to the left on this same page. Type in the text you want to add. Once you are done, click the save changes button at the bottom.
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{{Infobox_Disease
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| Name          = {{PAGENAME}}
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| Image          =
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| Caption        =
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| DiseasesDB    = 29612
 +
| ICD10          = {{ICD10|I|89|8|i|80}}, {{ICD10|J|91||j|90}}
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| ICD9          =  {{ICD9|457.8}}, {{ICD9|511.9}}
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| ICDO          =
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| OMIM          =
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| MedlinePlus    =
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| eMedicineSubj  = med
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| eMedicineTopic = 381
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| MeshID        = D002916
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}}
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{{SI}}
  
'''Chylothorax'''
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==Overview==
 +
A '''chylothorax''' is a type of [[pleural effusion]].  It results from lymphatic fluid accumulating in the [[pleural cavity]].
  
==== Editor-In-Chief: ==== Contact at [  @ ];  Phone:
+
==Historical Perspective==
  
Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please email [[mgibson@perfuse.org]] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.
+
==Classification==
----
 
  
= Overview = Associate Editor-In-Chief: Contact at [  @ ];  Phone:
+
==Pathophysiology==
* Chylothorax refers to leakage from the thoracic duct or other vessel caused by the presence of lymphatic fluid in the pleural space
+
 
+
==Causes==
===== References =====
+
Its cause is usually leakage from the [[thoracic duct]] or one of the main lymphatic vessels that drain to it. The most common causes are [[lymphoma]] and [[Physical trauma|trauma]] caused by thoracic surgery. The effusion is characteristically white and milky in appearance and contains high levels of triglycerides.
----
 
= Epidemiology and Demographics = Associate Editor-In-Chief: Contact at [ @ ]; Phone:
 
  
 +
In animals, chylothorax usually results from diseases that cause obstruction to the thoracic duct preventing lymph from draining normally into the venous system. Examples include tumors, heartworm disease, right sided cardiac failure, or idiopathic [[lymphangiectasia]]. The most effective form of treatment is surgical ligation of the thoracic duct combined with partial pericardectomy.<ref name="pmid9524635">{{cite journal |author=Birchard SJ, Smeak DD, McLoughlin MA |title=Treatment of idiopathic chylothorax in dogs and cats |journal=J. Am. Vet. Med. Assoc. |volume=212 |issue=5 |pages=652–7 |year=1998 |month=March |pmid=9524635 |doi= |url=}}</ref>
  
===== References =====
+
== Differential Diagnosis ==
= Differential Diagnosis = Associate Editor-In-Chief: Contact at [  @ ];  Phone:
 
 
* [[Cirrhosis]]
 
* [[Cirrhosis]]
 
* Congenital chylothorax
 
* Congenital chylothorax
Line 23: Line 35:
 
* Iatrogenic
 
* Iatrogenic
 
* Idiopathic
 
* Idiopathic
* Lymphomas
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* [[Lymphoma]]
* Nonlymphomatous malignancies
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* Nonlymphomatous [[malignancies]]
* Nonsurgical penetrating trauma
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* Nonsurgical penetrating [[trauma]]
* [[Tuberculosis]]
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* [[Tuberculosis]] <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>
  
===== References =====
+
==Epidemiology and Demographics==
----
+
* The prevalence of [disease name] is approximately [number or range] per 100,000 individuals worldwide.
= Diagnosis =  
+
* In [year], the incidence of [disease name] was estimated to be [number or range] cases per 100,000 individuals in [location].
 +
 +
===Age===
 +
*Patients of all age groups may develop [disease name].
 +
 +
*[Disease name] is more commonly observed among patients aged [age range] years old.
 +
*[Disease name] is more commonly observed among [elderly patients/young patients/children].
 +
 +
===Gender===
 +
*[Disease name] affects men and women equally.
 +
 +
*[Gender 1] are more commonly affected with [disease name] than [gender 2].
 +
* The [gender 1] to [Gender 2] ratio is approximately [number > 1] to 1.
 +
 +
===Race===
 +
*There is no racial predilection for [disease name].
 +
 +
*[Disease name] usually affects individuals of the [race 1] race.
 +
*[Race 2] individuals are less likely to develop [disease name].
 +
 +
==Risk Factors==
 +
*Common risk factors in the development of [disease name] are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
 +
 +
== Natural History, Complications and Prognosis==
 +
*The majority of patients with [disease name] remain asymptomatic for [duration/years].
 +
*Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
 +
*If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
 +
*Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
 +
*Prognosis is generally [excellent/good/poor], and the [1/5/10­year mortality/survival rate] of patients with [disease name] is approximately [#%].
 +
 +
== Diagnosis ==
 +
===Diagnostic Criteria===
 +
*The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
 +
:*[criterion 1]
 +
:*[criterion 2]
 +
:*[criterion 3]
 +
:*[criterion 4]
 +
 +
=== Symptoms ===
 +
*[Disease name] is usually asymptomatic.
 +
*Symptoms of [disease name] may include the following:
 +
:*[symptom 1]
 +
:*[symptom 2]
 +
:*[symptom 3]
 +
:*[symptom 4]
 +
:*[symptom 5]
 +
:*[symptom 6]
 +
 +
=== Physical Examination ===
 +
*Patients with [disease name] usually appear [general appearance].
 +
*Physical examination may be remarkable for:
 +
:*[finding 1]
 +
:*[finding 2]
 +
:*[finding 3]
 +
:*[finding 4]
 +
:*[finding 5]
 +
:*[finding 6]
 +
 +
=== Laboratory Findings ===
 +
*There are no specific laboratory findings associated with [disease name].
  
== History and Symptoms == Associate Editor-In-Chief: Contact at [ @ ];  Phone:
+
*A  [positive/negative] [test name] is diagnostic of [disease name].
 
+
*An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].
===== References =====
+
*Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
----
+
   
== Physical Examination == Associate Editor-In-Chief: Contact at [ @ ];  Phone:
+
===Imaging Findings===
 
+
*There are no [imaging study] findings associated with [disease name].
=== Appearance of the Patient ===
+
 
+
*[Imaging study 1] is the imaging modality of choice for [disease name].
=== Eyes ===
+
*On [imaging study 1], [disease name] is characterized by [finding 1], [finding 2], and [finding 3].
 
+
*[Imaging study 2] may demonstrate [finding 1], [finding 2], and [finding 3].
=== Ear Nose and Throat ===
+
   
 
 
=== Heart ===
 
 
 
=== Lungs ===
 
 
 
=== Abdomen ===
 
 
 
=== Extremities ===
 
 
 
=== Neurologic ===
 
 
 
=== Other ===
 
 
 
===== References =====
 
----
 
== Laboratory Findings ==
 
 
 
 
 
 
 
=== Electrolyte and Biomarker Studies === Associate Editor-In-Chief: Contact at [ @ ]; Phone:
 
 
 
 
 
=====References=====  
 
----
 
 
 
=== Electrocardiogram === Associate Editor-In-Chief: Contact at [ @ ];  Phone:
 
 
 
 
 
 
 
=====References=====
 
----
 
 
 
=== Chest X Ray === Associate Editor-In-Chief: Contact at [ @ ];  Phone:
 
 
 
 
 
=====References=====
 
----
 
 
 
=== MRI and CT === Associate Editor-In-Chief: Contact at [ @ ];  Phone:
 
 
 
 
 
=====References=====
 
----
 
 
 
=== Echocardiography or Ultrasound === Associate Editor-In-Chief: Contact at [ @ ]; Phone:
 
 
 
 
 
=====References=====
 
----
 
 
 
=== Other Imaging Findings ===
 
 
 
 
 
=====References=====
 
----
 
 
=== Other Diagnostic Studies ===
 
=== Other Diagnostic Studies ===
 
+
*[Disease name] may also be diagnosed using [diagnostic study name].
 +
*Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].
 +
 +
== Treatment ==
 +
=== Medical Therapy ===
 +
*There is no treatment for [disease name]; the mainstay of therapy is supportive care.
 +
 +
*The mainstay of therapy for [disease name] is [medical therapy 1] and [medical therapy 2].
 +
*[Medical therapy 1] acts by [mechanism of action 1].
 +
*Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].
 +
 +
=== Surgery ===
 +
*Surgery is the mainstay of therapy for [disease name].
 +
*[Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
 +
*[Surgical procedure] can only be performed for patients with [disease stage] [disease name].
 +
 +
=== Prevention ===
 +
*There are no primary preventive measures available for [disease name].
 
   
 
   
===== References =====
+
*Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].
----
 
 
 
= Treatment =
 
 
 
== Pharmacotherapy ==
 
 
 
=== Acute Pharmacotherapies === Associate Editor-In-Chief: Contact at [  @ ];  Phone:
 
 
 
===== References =====
 
----
 
 
 
=== Chronic Pharmacotherapies === Associate Editor-In-Chief: Contact at [  @ ];  Phone:
 
 
 
 
 
===== References =====
 
----
 
 
 
== Surgery and Device Based Therapy ==
 
 
 
 
 
=== Indications for Surgery === Associate Editor-In-Chief: Contact at [  @ ];  Phone:
 
 
 
 
 
===== References =====
 
----
 
=== Pre-Operative Assessment === Associate Editor-In-Chief: Contact at [  @ ];  Phone:
 
 
 
 
 
===== References =====
 
----
 
 
 
=== Post-Operative Management === Associate Editor-In-Chief: Contact at [  @ ];  Phone:
 
 
 
 
 
===== References =====
 
----
 
=== Transplantation === Associate Editor-In-Chief: Contact at [  @ ];  Phone:
 
 
 
 
 
===== References =====
 
----
 
= Pathophysiology & Etiology= Associate Editor-In-Chief: Contact at [  @ ];  Phone:
 
 
 
 
 
===== References =====
 
== Prevention ==
 
 
 
== Primary Prevention == Associate Editor-In-Chief: Contact at [  @ ];  Phone:
 
 
 
===== References =====
 
----
 
== Secondary Prevention == Associate Editor-In-Chief: Contact at [  @ ];  Phone:
 
 
 
 
 
===== References =====
 
----
 
== Cost-Effectiveness of Therapy == Associate Editor-In-Chief: Contact at [ @ ];  Phone:
 
 
 
 
 
===== References =====
 
----
 
== Future or Investigational Therapies == Associate Editor-In-Chief: Contact at [ @ ];  Phone:
 
 
 
 
 
===== References =====
 
----
 
 
 
==Suggested Revisions to the Current Guidelines== Associate Editor-In-Chief: Contact at [ @ ];  Phone:
 
 
 
 
 
== References ==
 
<biblio>
 
#sailer isbn=1591032016 Sailer, Christian, Wasner, Susanne.  Differential Diagnosis Pocket.  Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77-78
 
</biblio>
 
== Acknowledgements ==
 
The content on this page was first contributed by
 
 
 
List of contributors:
 
----
 
== Suggested Reading and Key General References ==
 
 
 
== Suggested Links and Web Resources ==
 
 
 
== For Patients ==
 
 
 
= Basic Instructions on Editing This Page =
 
 
 
== Please use this template for adding material regarding a disease state ==
 
 
 
It preserves a consistent look and feel to the site and makes navigation for others easier.
 
 
 
== How Do I Add Material ==
 
 
 
Click on the edit button at the top left. Next, simply type in the material that you wish to add under the appropriate heading. Use a paragraph break (enter button) to separate the lines. Check your addition to the page or editing by clicking on the preview button at the bottom. Next check your spelling. Finally, click the save changes button. It's that simple!
 
 
 
== Wiki doc Syntax ==
 
 
 
=== Headings ===
 
 
 
The headings have already been created for you on this page. Preserve them unless they are irrelevent to the disease state or topic
 
 
 
Use the headings syntax below to preserve the hierarchical nature of the page rather than simply adding text in '''bold'''. You can modify headings or add to them as follows:
 
 
 
The overall heading of the entire page is achieved by surround the word with with a single equal sign (=) to indicate that it is Subheading 1 or the Title of the page.
 
 
 
The second subheading is achieved with a space and two equal signs surrounding the word. A note of caution, you must put a space (hit the space bar once) around each side of the word!: == Subheading 2 ==
 
 
 
The third subheading is achieved with a space and three equal signs surrounding the word: === Subheading 3 ===
 
 
 
The same method is used for the fourth and fifth subheadings.
 
 
 
=== Bolding ===
 
  
Place 3 single quotes like these ' ' ' on each side of a word to make it '''bold''' (don't put spaces between the quotes!)
+
*Once diagnosed and successfully treated, patients with [disease name] are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].
  
=== Italicizing ===
+
== See also ==
 +
* [[Pleural effusion]]
  
Place 2 single quotes like these ' ' on each side of a word to make it ''italic'' (don't put spaces between the quotes!)
+
==References==
 +
{{reflist|2}}
  
=== Lists and Bullets ===
+
{{Vascular diseases}}
 +
{{Respiratory pathology}}
  
To create numbered list start a new line with a * for a bullet, # for a numbered list, or use the : symbol to insert a tab. e.g,
+
[[de:Chylothorax]]
* bullet
+
[[nl:Chylothorax]]
# numbered list
+
[[ja:乳び胸]]
 +
[[pl:Chylothorax]]
 +
[[pt:Quilotórax]]
  
=== Links ===
+
{{WH}}
To make a link, use the button at the top of the edit window; or use [[double brackets]]
+
{{WS}}
You can insert a [[Wiki Word]], a [[url]], or use [[url label]].
 
  
----
+
[[Category:Pulmonology]]
[[Category:Ddx:Chylothorax]]
 

Latest revision as of 18:49, 7 June 2016

Chylothorax
ICD-10 I89.8, J91
ICD-9 457.8, 511.9
DiseasesDB 29612
eMedicine med/381 
MeSH D002916

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Experimental / Informatics

List of terms related to Chylothorax

Overview

A chylothorax is a type of pleural effusion. It results from lymphatic fluid accumulating in the pleural cavity.

Historical Perspective

Classification

Pathophysiology

Causes

Its cause is usually leakage from the thoracic duct or one of the main lymphatic vessels that drain to it. The most common causes are lymphoma and trauma caused by thoracic surgery. The effusion is characteristically white and milky in appearance and contains high levels of triglycerides.

In animals, chylothorax usually results from diseases that cause obstruction to the thoracic duct preventing lymph from draining normally into the venous system. Examples include tumors, heartworm disease, right sided cardiac failure, or idiopathic lymphangiectasia. The most effective form of treatment is surgical ligation of the thoracic duct combined with partial pericardectomy.[1]

Differential Diagnosis

Epidemiology and Demographics

  • The prevalence of [disease name] is approximately [number or range] per 100,000 individuals worldwide.
  • In [year], the incidence of [disease name] was estimated to be [number or range] cases per 100,000 individuals in [location].

Age

  • Patients of all age groups may develop [disease name].
  • [Disease name] is more commonly observed among patients aged [age range] years old.
  • [Disease name] is more commonly observed among [elderly patients/young patients/children].

Gender

  • [Disease name] affects men and women equally.
  • [Gender 1] are more commonly affected with [disease name] than [gender 2].
  • The [gender 1] to [Gender 2] ratio is approximately [number > 1] to 1.

Race

  • There is no racial predilection for [disease name].
  • [Disease name] usually affects individuals of the [race 1] race.
  • [Race 2] individuals are less likely to develop [disease name].

Risk Factors

  • Common risk factors in the development of [disease name] are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].

Natural History, Complications and Prognosis

  • The majority of patients with [disease name] remain asymptomatic for [duration/years].
  • Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
  • If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
  • Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
  • Prognosis is generally [excellent/good/poor], and the [1/5/10­year mortality/survival rate] of patients with [disease name] is approximately [#%].

Diagnosis

Diagnostic Criteria

  • The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
  • [criterion 1]
  • [criterion 2]
  • [criterion 3]
  • [criterion 4]

Symptoms

  • [Disease name] is usually asymptomatic.
  • Symptoms of [disease name] may include the following:
  • [symptom 1]
  • [symptom 2]
  • [symptom 3]
  • [symptom 4]
  • [symptom 5]
  • [symptom 6]

Physical Examination

  • Patients with [disease name] usually appear [general appearance].
  • Physical examination may be remarkable for:
  • [finding 1]
  • [finding 2]
  • [finding 3]
  • [finding 4]
  • [finding 5]
  • [finding 6]

Laboratory Findings

  • There are no specific laboratory findings associated with [disease name].
  • A [positive/negative] [test name] is diagnostic of [disease name].
  • An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].
  • Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].

Imaging Findings

  • There are no [imaging study] findings associated with [disease name].
  • [Imaging study 1] is the imaging modality of choice for [disease name].
  • On [imaging study 1], [disease name] is characterized by [finding 1], [finding 2], and [finding 3].
  • [Imaging study 2] may demonstrate [finding 1], [finding 2], and [finding 3].

Other Diagnostic Studies

  • [Disease name] may also be diagnosed using [diagnostic study name].
  • Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].

Treatment

Medical Therapy

  • There is no treatment for [disease name]; the mainstay of therapy is supportive care.
  • The mainstay of therapy for [disease name] is [medical therapy 1] and [medical therapy 2].
  • [Medical therapy 1] acts by [mechanism of action 1].
  • Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].

Surgery

  • Surgery is the mainstay of therapy for [disease name].
  • [Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
  • [Surgical procedure] can only be performed for patients with [disease stage] [disease name].

Prevention

  • There are no primary preventive measures available for [disease name].
  • Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].
  • Once diagnosed and successfully treated, patients with [disease name] are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].

See also

References

  1. Birchard SJ, Smeak DD, McLoughlin MA (1998). "Treatment of idiopathic chylothorax in dogs and cats". J. Am. Vet. Med. Assoc. 212 (5): 652–7. PMID 9524635. Unknown parameter |month= ignored (help)
  2. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  3. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X


de:Chylothorax nl:Chylothorax


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