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Ascites

Ascites - abnormal accumulation of free fluid in the abdomen (often) occurs as a result of the following reasons: kantseromatoz peritoneum, retroperitoneal lymph node metastatic lesions, accompanied by violation of lymph, hypoalbuminemia, profound violation salt obinu (as a consequence of high levels of aldosterone) supporting cardiogenic pathology.

Clinical manifestations of ascites depends on the amount of free fluid: increased abdominal discomfort in the abdomen, feeling of fullness, indigestion, belching, reflux, nausea and vomiting, shortness of breath, swelling of the lower extremities.

Conservative treatment of ascites include application specific anticancer chemotherapy (including intravenous, intraperitoneal or endolymphatic) treatment of accompanying diseases, if it is the cause of fluid accumulation, use of diuretics.

In cases when conservative therapy is ineffective, requires evacuation of fluid through celiocentesis. This surgical manipulation should be carried out in strict accordance with the principles of asepsis and antisepsis, a doctor who has relevant experience. After manipulation morning nakladuyetsya bandage and, in most cases, to prevent leakage of ascitic fluid - seam. The bandage should be kept until they are healed. In principle, it is possible and permanent drainage of the abdominal cavity, but in practice it is rarely used, often performing repeated puncture of the abdominal cavity. Treatment of ascites does not require adherence to a special diet, with some restrictions salty foods. No need to control and fluid intake. Eating should be smaller portions, but more often.

Hydrothorax

Hydrothorax (pleural effusion) are often complicates the course of disseminated tumor. Frequently the cause of fire: kantseromatoz pleura, lymph violation snaslidok metastatic mediastinal lymph nodes, supporting cardiogenic pathology.

Hydrothorax greatly enhances the patient's condition, manifesting painful dyspnea and respiratory insufficiency. On physical examination bugged weakened sharply against the backdrop of breath shortening percussion. Radiographically determined eclipse corresponding part of the chest, which merges with the shadow of the diaphragm. If the pleural cavity is defined horizontal level, it is about hidropnevmotoraks.

Conservative therapy for hydrothorax conducted on the same principles as in ascites. However, the only effective way to eliminate it is pleural puncture with evacuation of fluid. This manipulation should be performed by a medical expert in a hospital or clinic, equipped with X-ray equipment. In extreme cases, for special reasons (non-transportable condition of the patient), pleural puncture can be performed at home. The doctor performing such manipulation should be aware of the risk of complications related to pleural puncture (pneumothorax, bleeding) and be ready to eliminate them in nelikarnyanyh conditions. Mandatory rules is to monitor patients for 1.5-2 hours after puncture for early diagnosis of pneumothorax. When suspected his development to X-Ray.

Permanent thoracostomy is used quite often in the case of pnevmohidrotoraksu or if unsuccessful conservative treatment of pleurisy. Patients with pleural drainage may, if necessary, be located at home. Caring for them includes prevention of infection and ensure hermetyzmu (drainage by Byulau), under the constant supervision of the surgeon.

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