title: Hepatic hydrothorax: pathogenesis, diagnosis, and management.
abstract: Hepatic hydrothorax is defined as a pleural effusion in a patient with cirrhosis of the liver and no cardiopulmonary disease. The estimated prevalence of this often debilitating complication in patients with liver cirrhosis is 4% to 10%. Its pathophysiology involves movement of ascitic fluid from the peritoneal cavity into the pleural space through diaphragmatic defects. As a result patients are at increased risk of respiratory infection. Initial management consists of sodium restriction, diuretics, and thoracentesis. A transjugular intrahepatic portosystemic shunt may be required. Because most patients with hepatic hydrothorax have end-stage liver disease, a liver transplant should be considered if these options fail.
authors.affiliation: Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA.
authors.forename: K N
authors.initials: KN
authors.lastname: Lazaridis
authors.forename: J W
authors.initials: JW
authors.lastname: Frank
authors.forename: M J
authors.initials: MJ
authors.lastname: Krowka
authors.forename: P S
authors.initials: PS
authors.lastname: Kamath
mesh_terms: D000465:Algorithms; D003937:Diagnosis, Differential; D003964:Diaphragm / Q000002:abnormalities / Q000601:surgery; D004232:Diuretics / Q000627:therapeutic use; D006801:Humans; D006876:Hydrothorax / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D008103:Liver Cirrhosis / Q000150:complications*; D010536:Peritoneovenous Shunt; D010996:Pleural Effusion / Q000150:complications* / Q000209:etiology; D018700:Pleurodesis; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D013906:Thoracoscopy; D013907:Thoracostomy
chemical_list: D004232:Diuretics