Successful treatment of hepatic hydrothorax with octreotide.
Hepatic hydrothorax is a rare complication of cirrhosis. Controlling ascites formation is the goal of therapy. We report the case of an adult patient presenting with alcoholic cirrhosis who developed first a symptomatic hydrothorax, refractory to diuretics and fluid and sodium restriction, and then an hepatorenal syndrome. Treatment consisted of chest tube insertion and 5 days' intravenous infusion of octreotide. Complete clinical and biological data were reviewed. Octreotide administration resulted in an increased urinary outflow and sodium output, concomitant with improved renal function. The patient has been free of symptoms after discharge from hospital for a follow-up period of 5 months. This observation raises interesting issues regarding the possible utility of splanchnic vasoconstrictors, reducing portal hypertension, in the treatment of refractory hepatic hydrothorax.
Fédération des Spécialités Digestives, Hôpital Edouard Herriot, Lyon, France. jdumortier@lyon151.inserm.fr
J
J
Dumortier
J
J
Leprêtre
O
O
Scalone
O
O
Boillot
J Y
JY
Scoazec
B
B
Delafosse
J A
JA
Chayvialle
D004322:Drainage / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006530:Hepatorenal Syndrome / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D006876:Hydrothorax / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology*; D007262:Infusions, Intravenous; D007677:Kidney Function Tests; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications*; D008875:Middle Aged; D015282:Octreotide / Q000008:administration & dosage*; D011859:Radiography; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*
D014662:Vasoconstrictor Agents; D015282:Octreotide