Serous Fluid PDF

Serous Fluid  Serous fluid Serous effusion is defined as an excessive accumulation of fluid in a body cavity, which includes :- The pleural The Pericardial The peritoneal Cytological evaluation of serous fluid is useful for detecting underlying...

Serous Fluid  Serous fluid Serous effusion is defined as an excessive accumulation of fluid in a body cavity, which includes :- The pleural The Pericardial The peritoneal Cytological evaluation of serous fluid is useful for detecting underlying etiologies, such as malignancy, and evaluating tumor stage, as well as providing information for treatment customization.  Pleural Effusion Pleural effusion, which some people call “water on the lungs,” is the buildup of excess fluid between the layers of the pleura outside your lungs. The pleura are thin membranes that line your lungs and the inside of your chest cavity. Normally, everyone has a small amount of fluid in their pleura. This fluid acts as a natural lubricant and makes it easier for your lungs to move when you breathe. But with pleural effusion, you have too much fluid around your lungs. This means your body is producing too much of the fluid or not absorbing enough of the fluid it makes.  Types of pleural effusion Pleural effusion divided into two types, depending on the kind of fluid around your lungs. Excess fluid may be: Protein-poor and watery (transudative). Fluid of this kind comes from cirrhosis or heart failure, for example. This type of pleural effusion happens when there’s an increase in pressure from the fluid. Protein-rich (exudative). Fluid of this kind comes from cancer or an infection, for example. This type of pleural effusion happens because too much fluid is getting through your smallest blood vessels or your lymphatic system isn’t draining enough. What are the symptoms of pleural effusion? You may have unrelated symptoms due to the disease or condition that caused pleural effusion. Pleural effusion symptoms include: Chest pain Coughing or deep breathing makes it worse. Dyspnea (shortness of breath, or difficult, labored breathing). Orthopnea (the inability to breathe easily unless you’re sitting up straight or standing up straight).  What causes pleural effusion? The most common causes of transudative (watery fluid) pleural effusions include: Heart failure. Cirrhosis. Nephrotic syndrome (a kidney issue)  Cont.. Common causes of exudative (protein-rich fluid) pleural effusions include: Pneumonia. Cancer (lung cancer, breast cancer or lymphoma). Kidney disease. Inflammatory disease. Post open-heart surgery.  Less common causes of pleural effusion include: Tuberculosis Autoimmune disease. Bleeding from chest trauma. Chylothorax (chyle from your lymphatic system after trauma). Rare chest and abdominal infections. Exposure to asbestos. Esophageal rupture. Pancreatitis Meig’s syndrome (from a benign ovarian tumor). Ovarian hyperstimulation syndrome. Certain medications. Abdominal surgery. Radiation therapy  Exams and Tests Your provider may want to perform tests on the fluid. If so, a sample of fluid is removed with a needle inserted between the ribs. Tests on the fluid will be done to look for: Infection Cancer cells Protein levels Cell counts Acidity of the fluid (sometimes) Blood tests that may be done include: Complete blood count (CBC), to check for signs of infection or anemia Kidney and liver function blood tests  Cont.. If needed, these other tests may be done: Ultrasound of the heart (echocardiogram) to look for heart failure Ultrasound of abdomen and liver Urine protein testing Lung biopsy to look for cancer Passing a tube through the windpipe to check the airways for problems or cancer (bronchoscopy) Pericardial Effusion Pericardial effusion is a buildup of fluid in the space around your heart. It can happen for many reasons, like infections, injuries or other medical conditions. If the buildup is severe or happens quickly, it can compress your heart and cause a life-threatening medical emergency.  Cont.. When a pericardial effusion happens slowly, your pericardium (the sac around your heart) has time to stretch and make room for the extra fluid. When it happens quickly, your pericardium doesn’t have time to stretch. The fluid buildup puts more and more pressure on your heart. This leaves your heart’s chambers without room to expand and fill up. Because of this, your heart pumps less blood, depriving your organs of blood flow.  Cont.. An easy way to see how pericardial effusion affects your heart is by trying to blow up a balloon inside of a plastic bottle. In this example, your heart is the balloon and the bottle is the pericardium. When the bottle is empty, there’s more space for the balloon to inflate. If you add water to the bottle, there’s less space and you can’t blow up the balloon as much. If you keep filling the bottle, eventually, you can’t blow up the balloon at all.  Cont.. A pericardial effusion can lead to cardiac tamponade. Between the inner wall of the pericardium and your heart is a thin layer of fluid. This cushions and protects your heart from outside forces (much like bubble wrap around a fragile item inside a shipping box). Usually, your pericardium has just enough fluid to cushion your heart, but not so much fluid that it keeps your heart from expanding and filling up with blood. Cardiac tamponade happens when your heart has no room to expand and fill with blood. Without quick treatment, it can make your heart stop, which is eventually fatal within minutes to hours.  Cont.. Cardiac tamponade is a complication of pericardial effusion, but not the only one. As your heart pumps less and less blood, it speeds up to try to make up for its limited pumping ability. Over time, your heart can’t keep up, and you can go into cardiogenic shock. Without treatment, cardiogenic shock is fatal  What are the symptoms? The main symptoms of pericardial effusions and cardiac tamponade include: Shortness of breath (dyspnea). Chest pressure or pain. Fast heartbeat or heart palpitations. Lightheadedness or dizziness. Fainting (syncope). Fatigue. Anxiety, confusion or other behavior changes (because of low blood flow to your brain). Cyanosis (a blue or gray tinge to your lips or under your fingernails that happens when you have low blood oxygen levels).  Cont.. If a pericardial effusion is large enough, it can press on surrounding tissues or nerves. That can cause symptoms like: Trouble swallowing (dysphagia). Hiccups. Coughing or hoarseness  What causes pericardial effusion? Possible causes of pericardial effusion include: Infections. Pericardial effusion often happens because of viral or bacterial infections, including human immunodeficiency virus (HIV) and tuberculosis. It can also happen because of fungal infections or parasites. Pericardial effusion itself isn’t contagious. Cancer. Tumors in your heart or that spread from elsewhere in your body can damage your pericardium. Immune system conditions or inflammatory disorders. These include lupus, rheumatoid arthritis or Sjögren’s syndrome. Hormonal disorders or problems. An example of this is hypothyroidism (where your thyroid gland isn’t producing enough thyroid hormone).  Cont.. Trauma. Injuries to your chest, including blunt impacts (like car crashes) and punctures from knives or bullets, can cause pericardial effusion. Heart or circulatory problems. These include heart attacks, heart valve disease or aortic dissection (where layers on the inside of your aorta separate or tear). Medical causes. Pericardial effusion can happen after heart surgery, radiation therapy for cancer or as a side effect of some medications. Other. Pericardial effusion can also happen with heart failure, chronic kidney disease, kidney failure or liver cirrhosis.  Tests used to diagnose this condition The possible tests include: Complete blood count (CBC). Troponin. B-type natriuretic peptide. Thyroid-stimulating hormone. Immune system tests (to look for immune system disorders or inflammatory conditions).  Peritoneal fluid Peritoneal fluid is a serous fluid made by the peritoneum in the abdominal cavity which lubricates the surface of tissue that lines the abdominal wall and pelvic cavity. It covers most of the organs in the abdomen. An increased volume of peritoneal fluid is called ascites.  What is Ascites? Ascites is when too much fluid builds up in your abdomen (belly). This condition often happens in people who have cirrhosis (scarring) of the liver. A sheet of tissue called the peritoneum covers the abdominal organs, including the stomach, bowels, liver and kidneys. The peritoneum has two layers. Ascites happens when fluid builds up between the two layers  What causes ascites? Cirrhosis is the most common cause of ascites. Other conditions that can cause it include heart failure, kidney failure, infection or cancer. When you have cirrhosis, your liver doesn’t function as it should. The decrease in liver function combines with portal hypertension to cause ascites symptoms. Portal hypertension is high pressure in the portal vein that delivers blood to your liver. The high pressure causes fluid to leak out of your veins into your belly and collect there.  What are the symptoms of ascites? The main symptoms of ascites are a large belly and rapid weight gain. Other symptoms include: Swelling in your ankles. Shortness of breath. Digestive issues, such as bloating, abdominal pain, loss of appetite, indigestion and constipation. Back pain. Difficulty sitting. Fatigue.  Peritoneal fluid analysis Your health care provider will clean and numb a small area of your belly area (abdomen). A needle is inserted through the skin of your abdomen and a fluid sample is pulled out. The fluid is collected into a tube (syringe) attached to the end of the needle. The fluid is sent to a lab where it is examined. Tests will be done on the fluid to measure: Albumin Protein Red and white blood cell counts  Cont.. Tests will also check for bacteria and other types of infection. The following tests may also be done: Alkaline phosphatase Amylase Cytology (appearance of cells) Glucose LDH  Why the Test is Performed The test is done to: Detect peritonitis (infection in the peritoneal space). Find the cause of fluid in the abdomen. Remove large amounts of fluid from the peritoneal space in people who have liver disease. (This is done to make breathing comfortable.) See whether an injury to the abdomen has caused internal bleeding.  What Abnormal Results Mean Abnormal results may mean: Bile-stained fluid may mean you have a gallbladder or liver problem. Bloody fluid may be a sign of tumor or injury. High white blood cell counts may be a sign of peritonitis. Milk-colored peritoneal fluid may be a sign of carcinoma (a type of cancer), cirrhosis of the liver, lymphoma, tuberculosis, or infection. Other abnormal test results may be due to a problem in the intestines or organs of the abdomen. Large differences between the amount of albumin in the peritoneal fluid and in your blood may point to heart, liver, or kidney failure. Small differences may be a sign of cancer or infection.