title: Resistant hepatic hydrothorax: a successful case with treatment by nCPAP.
abstract: Hepatic hydrothorax is defined as pleural effusion with liver cirrhosis but no primary cardiopulmonary disease. Hepatic hydrothorax is often resistant to various therapeutic interventions. The most likely cause is the transfer of ascites fluid from the abdomen to the pleural space via the diaphragm because of a negative intrathoracic pressure gradient. A 62-year-old man was diagnosed with hepatoma and cirrhosis. After a partial hepatectomy, he suffered with hepatic hydrothorax. He had snoring without obvious sleep apnea. The patient's hepatic hydrothorax markedly improved following nasal continuous positive airway pressure (nCPAP) treatment during sleep. The mechanism for the improvement may have been the intrathoracic positive pressure during sleep induced by the nCPAP treatment during sleep. nCPAP treatment may provide a new therapy for resistant hepatic hydrothorax.
authors.affiliation: Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto University Hospital, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Takahashi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Chin
authors.forename: Kensuke
authors.initials: K
authors.lastname: Sumi
authors.forename: Takaya
authors.initials: T
authors.lastname: Nakamura
authors.forename: Hisako
authors.initials: H
authors.lastname: Matsumoto
authors.forename: Akio
authors.initials: A
authors.lastname: Niimi
authors.forename: Iwao
authors.initials: I
authors.lastname: Ikai
authors.forename: Michiaki
authors.initials: M
authors.lastname: Mishima
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D006801:Humans; D006876:Hydrothorax / Q000209:etiology / Q000628:therapy*; D008103:Liver Cirrhosis / Q000150:complications; D008107:Liver Diseases / Q000209:etiology / Q000628:therapy*; D008113:Liver Neoplasms / Q000150:complications / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome