Bloody exudate

Introduction The exudate may be serous fibrin, serous, hemorrhagic or suppurative. Bloody exudate is more common in diseases caused by inflammation and tumors. At the onset of inflammation, exudates of fibrin, leukocytes, and endothelial cells appear in the parietal and visceral pericardium. After the liquid in the exudate increases, it becomes a serous fibrinous exudate, the amount can reach 2~3L, the appearance is grass yellow, clear, or turbid due to more white blood cells and endothelial cells; if more Red blood cells are serous and bloody. The exudate is absorbed in 2 to 3 weeks.

Cause

The cause of bloody exudate

Mostly caused by inflammation, tumors, etc.

an examination

Related inspection

Cardiovascular angiography liver, gallbladder, spleen CT examination chest CT examination

Blood exudate examination

Can be seen in pericardial tumors. The performance is: 1 pericardial exudate, especially bloody exudate. 2 The outline of the heart shadow is abnormal, and the local part has a block shadow. 3 no cause of pericardial tamponade symptoms. 4 unexplained chest pain, jugular vein engorgement. A reliable diagnosis is to find tumor cells in the extracted fluid. Secondly, the pericardial puncture was injected into the pericardial cavity. X-ray examination showed that the heart shadow was enlarged, the pericardium had effusion, and there was a shadow on the pericardium. Echocardiography can show pericardial effusion or substantial lumps.

Also seen in the inflammation of the pericarditis. At the onset of inflammation, exudates of fibrin, leukocytes, and endothelial cells appear in the parietal and visceral pericardium. After the liquid in the exudate increases, it becomes a serous fibrinous exudate, the amount can reach 2~3L, the appearance is grass yellow, clear, or turbid due to more white blood cells and endothelial cells; if more Red blood cells are serous and bloody. The exudate is absorbed in 2 to 3 weeks. Tuberculous pericarditis often produces a large amount of serous fibrin or serous blood exudate. The exudate can last for several months and occasionally accumulate. The exudate of suppurative pericarditis contains a large number of neutrophils, which are thick pus. Cholesterol pericarditis exudate contains a lot of cholesterol, which is golden yellow. The exudate of chylorrhea is milky. Hemorrhagic pericarditis caused by tuberculosis or neoplasms contains a large amount of red blood cells, which should be differentiated from bloody pericardium containing pure blood by trauma or anticoagulant. The inflammatory response often involves the myocardium in the lower part of the pericardium. A few severe cases can affect the deep myocardium and even spread to the mediastinum, hernia and pleura. After the pericarditis is healed, local small plaques, general pericardial thickening, or different degrees of adhesion may remain. Adhesion can completely block the pericardial cavity. If inflammation affects the outer surface of the wall of the wall, it can cause adhesion of the heart to adjacent tissues such as the pleura, mediastinum and sputum. Inflammatory exudate of acute fibrinous pericarditis can often be completely dissolved and absorbed, or exist for a long time, can also be mechanized, replace scars formed by connective tissue, and even cause pericardial calcification, and eventually develop into constrictive pericarditis.

Differential diagnosis

Bloody exudate confusing symptoms

1. Primary pericardial tumor: primary pericardial malignant tumor is rare, with mesothelioma predominating, followed by benign localized fibrosarcoma, malignant fibrosarcoma, angiosarcoma, lipoma and liposarcoma, benign and primary Sexually malignant teratoma, a rare pericardial tumor, occasionally coexisting with congenital diseases, such as tuberous sclerosis, secreting catecholamine pheochromocytoma, is also a rare primary pericardial tumor, in some AIDS patients Because of Kaposi's sarcoma and cardiac lymphoma, the number of cases of pericardium and cardiac malignant tumors increases. Cardiac tamponade may occur in the early stage of HIV infection. It must be differentiated from suppurative pericarditis and pericardial malignant tumors to rule out these diseases.

2. Pericardial metastasis: The metastasis of cancer has a mediastinal malignant tumor spread and attached to the pericardium, 2 tumor nodules deposited by the blood or lymphatic dissemination in the pericardium, 3 diffuse infiltrates of the tumor, 4 primary pericardial tumor, pericardium Local infiltration of the membrane, in most cases, the epicardium and myocardium are not involved.

3. Neoplastic pericardial effusion: neoplasmic pericardial effusion appears serous blood, rapid development, can cause acute or subacute cardiac tamponade, pericardial tumors such as sarcoma, mesothelioma and melanoma, can rupture ventricular and pericardial cavity Internal blood vessels, causing acute pericardial dilatation and accidental fatal cardiac tamponade, pericardial thickening and pericardial effusion (exudation-constrictive pericarditis) or tumor growth envelop the entire heart. Forming constrictive pericarditis.

4. Mediastinal tumor complicated with pericardial effusion: not all malignant, mediastinal lymphoma and Hodgkin's disease often appear asymptomatic pericardial effusion, these temporary pericardial effusion, presumably may be the result of lymphatic drainage disorder, mediastinal thymoma and Primary cardiac tumors can also be complicated by temporary pericardial effusion.

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