Aspectos toracoscopicos de la tuberculosis pleural
Thoracoscopic findings in pleural tuberculosis
F. Sebastian Quetglas, J. Cosano Povedano, L.M. Entrenas Costa, J. Lopez Pujol
Servicio Cirugía Torácica. Hospital Reina Sofía. Córdoba
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"apellidos" => "Molina" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615322067?idApp=UINPBA00003Z" "url" => "/03002896/0000002100000001/v1_201509151141/S0300289615322067/v1_201509151141/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "titulo" => "Aspectos toracoscopicos de la tuberculosis pleural" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "14" "paginaFinal" => "18" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "F. Sebastian Quetglas, J. Cosano Povedano, L.M. Entrenas Costa, J. Lopez Pujol" "autores" => array:4 [ 0 => array:2 [ "nombre" => "F." "apellidos" => "Sebastian Quetglas" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Cosano Povedano" ] 2 => array:2 [ "nombre" => "L.M." "apellidos" => "Entrenas Costa" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Lopez Pujol" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio Cirugía Torácica. Hospital Reina Sofía. Córdoba" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Thoracoscopic findings in pleural tuberculosis" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "1984-04-12" "fechaAceptado" => "1984-10-07" "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Dentro del contexto general de la patología pleural, el derrame de etiología tuberculosa constituye, todavía, una entidad de frecuencia elevada. El diagnóstico del mismo se ha visto notablemente mejorado desde que introdujeron en los protocolos de su estudio la realización de biopsias pleurales.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">En los últimos dos años se han practicado en el Servicio de Cirugía Torácica de la Ciudad Sanitaria Reina Sofía de Córdoba, 90 toracoscopias de las cuales en 18 casos (20%), obtuvimos un diagnóstico final de tuberculosis pulmonar o/y pleural. Todos estos enfermos siguieron un protocolo de estudio que básicamente comprende: historia clínica y examen físico; estudios bioquímicos en sangre periférica; estudio en líquidos pleurales extraídos por punción torácica y toracoscopia diagnóstica. Desde el punto de vista clínico, el análisis de los datos por nosotros obtenidos, revela en los enfermos portadores de TBC pleural, características clínicas similares, obteniendo en dichos estudios alteraciones clásicas en este tipo de derrames. Para el diagnóstico etiológico, la baciloscopia en líquido pleural fue positiva en un 5%, los cultivos pleurales del líquido en un 11%, el cultivo de las biopsias pleurales en un 11%, el examen histopatológico de la pieza obtenida por toracoscopia en un 95%. La presencia de bacilos ácido-alcohol resistentes en dichas muestras pleurales fue positivo en el 16% de los casos.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Desde el punto de vista toracoscópico encontramos imágenes que calificamos muy sugestivas de tuberculosis pleural en 13 casos, constituidas éstas por pleuras parietales uniformemente enrojecidas sobre las cuales constatábamos la presencia de pequeños nodulos de algunos milímetros de diámetro o placas blanquecinas de diámetro que oscilaba entre 1 y varios centímetros. Asimismo encontramos otro tipo de lesiones pleurales que consideramos como compatibles de TBC pleural, constituidas fundamentalmente por pleura uniformemente enrojecida sin formaciones nodulares o pleura totalmente fibrosada blanquecina.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">En resumen y, en nuestra opinión, la realización de biopsias pleurales por toracoscopia obtiene el más alto índice de positividades diagnósticas. Asimismo existen imágenes macroscópicas que permiten realizar diagnósticos de sospecha. El drenaje pleural que acompaña a la realización de toda toracoscopia unido al tratamiento médico acelera de forma importante el proceso curativo del enfermo.</p></span>" ] "en" => array:1 [ "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The incidence of tuberculous pleural effusion still rematas high within general pleural disorders. The diagnosis of the entity has been greatly aided by the introduction of pleural biopsy as part of the diagnostic protocol.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Over the last two years a total of 90 thoracoscopies were performed at the Service for Surgery of the Thorax at the Reina Sofía Hospital in Córdoba, Spain. Of these, 18 (20%) resulted in a definite diagnosis of pleural or pulmonary tuberculosis or both.</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The diagnostic protocol for all patients included: clinical history and physical examination, analysis of peripheral blood, culture of pleural fluid obtained with needle biopsy and thoracoscopy. When findings were analyzed it was found that all patients with pleural tuberculosis has similar clinical characteristics with alterations typical of pleural effusion.</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Tubercule bacilli were seen in 5% of all fluid samples, culture was positive in 11%, culture of the pleural biopsy specimens in 11% and histopathology of biopsy specimens obtained with thoracoscopy in 95%, acidalcohol resistant bacilli were found in 16% of all pleural fluid samples.</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Thoracoscopy showed images suggesting pleural tuberculosis in 13 cases; these included reddened walls with small tubercles of a few mm in diameter or white plaques ranging from 1 to several mm in diameter studding the surfaces.</p><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Other lesions compatible with pleural tuberculosis were also found, particularly reddened pleura without tubercles or white fibrous pleura.</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">In summary: thoracoscopy for pleural biopsy is the technique with which the highest number of positive diagnoses were obtained. There also are macroscopic images suggesting a suspected diagnosis of pleural tuberculosis. Pleural drainage accompanying thoracoscopy accelerates the healing process.</p></span>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografia" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:14 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Resultats de la biopsie plevrale al’aiguille" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Huguenin" 1 => "A. 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| 2020 May | 20 | 6 | 26 |
| 2020 April | 16 | 10 | 26 |
| 2020 March | 10 | 21 | 31 |
| 2020 February | 26 | 11 | 37 |
| 2020 January | 27 | 14 | 41 |
| 2019 December | 21 | 19 | 40 |
| 2019 November | 10 | 2 | 12 |
| 2019 October | 12 | 11 | 23 |
| 2019 September | 13 | 25 | 38 |
| 2019 August | 8 | 15 | 23 |
| 2019 July | 11 | 27 | 38 |
| 2019 June | 20 | 24 | 44 |
| 2019 May | 9 | 20 | 29 |
| 2019 April | 32 | 47 | 79 |
| 2019 March | 8 | 15 | 23 |
| 2019 February | 7 | 6 | 13 |
| 2019 January | 9 | 6 | 15 |
| 2018 December | 7 | 17 | 24 |
| 2018 November | 12 | 13 | 25 |
| 2018 October | 18 | 10 | 28 |
| 2018 September | 13 | 6 | 19 |
| 2018 May | 8 | 2 | 10 |
| 2018 April | 12 | 9 | 21 |
| 2018 March | 8 | 7 | 15 |
| 2018 February | 11 | 12 | 23 |
| 2018 January | 5 | 1 | 6 |
| 2017 December | 9 | 17 | 26 |
| 2017 November | 7 | 6 | 13 |
| 2017 October | 6 | 8 | 14 |
| 2017 September | 5 | 12 | 17 |
| 2017 August | 9 | 19 | 28 |
| 2017 July | 9 | 11 | 20 |
| 2017 June | 10 | 29 | 39 |
| 2017 May | 15 | 19 | 34 |
| 2017 April | 7 | 10 | 17 |
| 2017 March | 6 | 43 | 49 |
| 2017 February | 10 | 5 | 15 |
| 2017 January | 5 | 8 | 13 |
| 2016 December | 11 | 5 | 16 |
| 2016 November | 22 | 19 | 41 |
| 2016 October | 22 | 17 | 39 |
| 2016 September | 23 | 13 | 36 |
| 2016 August | 23 | 5 | 28 |
| 2016 July | 26 | 6 | 32 |
| 2016 June | 29 | 12 | 41 |
| 2016 May | 20 | 6 | 26 |
| 2016 April | 24 | 0 | 24 |
| 2016 March | 14 | 0 | 14 |
| 2016 February | 13 | 1 | 14 |
| 2016 January | 8 | 5 | 13 |
| 2015 December | 32 | 13 | 45 |
| 2015 November | 35 | 7 | 42 |
| 2015 October | 5 | 1 | 6 |
| 2015 September | 1 | 0 | 1 |
Show all
