Chemical pleurodesis for hepatic hydrothorax.
BACKGROUND
Ascites can occur after hepatic diseases causing dyspnea, coughing and pain. When associated with pleural effusion it can also increase respiratory distress. In a bibliographic survey hydrothorax has been observed in up to 20% of the patients and the kind of treatment is still being discussed.


OBJECTIVE
This case report shows the occurrence of a large volume of ascites and pleural effusion in a cirrhotic patient and his treatment.


METHODS
Report the case of a patient with hepatic cirrhosis due to chronic alcoholism and massive pleural effusion and ascites. He was submitted to several pleural paracenteses without success. Scintigraphy showed the presence of ascites and confirmed a possible pleuroperitoneal communication. The thoracic surgery group was called and after evaluation it was decided to submit the patient to a pulmonary decortication and chemical pleurodesis.


RESULTS
These procedures were carried out with success. The pleural effusion was solved and the treatment of ascites was decided upon because the patient did not accept any surgical procedure.


CONCLUSIONS
This treatment could be applied to patients with hydrothorax who could not be submitted to a liver transplantation.
Boin
I F
IF
Department of Surgery, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil. ilka@fcm.unicamp.br
Silva
A M
AM
Leonardi
L S
LS
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001201:Ascites / Q000209:etiology / Q000628:therapy; D006801:Humans; D006876:Hydrothorax / Q000209:etiology / Q000628:therapy*; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications* / Q000628:therapy; D008297:Male; D019152:Paracentesis; D018700:Pleurodesis / Q000379:methods*; D013752:Tetracycline / Q000008:administration & dosage*
D000900:Anti-Bacterial Agents; D013752:Tetracycline