Evaluación del Paciente con Derrame Pleural
Evaluación del Paciente con Derrame Pleural
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Derrames Pleurales son de presentación muy frecuente y son encontrados en pacientes de todas las especialidades clínicas y quirúrgicas. La incidencia anual de nuevos casos de derrames pleurales se calcula es de aproximadamente 1.5 millones en Estados Unidos. La Toracentesis es un procedimiento diagnostico muy simple que se puede hacer en el Consultorio, en la habitación del paciente, en las unidades de cuidado intensivo o en una sala de procedimientos. El estudio del líquido pleural no necesariamente hará diagnósticos exactos pero será una guía muy importante para la orientación clínica del caso. Una cuidadosa y completa historia clínica, un examen clínico completo y detallado, exámenes de laboratorio clínico, una adecuada interpretación de las imágenes radiológicas, previo a la toracentesis diagnóstica, logran con mucha frecuencia hacer un diagnóstico y una orientación adecuada de la investigación de cada caso individual. En este capítulo no solamente desarrollaré el tema acerca del análisis del liquido pleural sino que también resaltaré la importancia de algunos detalles de la historia clínica, del examen físico, de la radiología que conducirán a un diagnóstico diferencial adecuado previo a la Toracentesis diagnóstica.
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