Hepatic hydrothorax -- how would you manage it?
A 53-year-old woman with a history of chronic alcoholism presented with symptomatic large right-sided pleural effusion with no evidence of ascites. After a diagnosis of hepatic hydrothorax was established, her symptoms improved with therapeutic thoracentesis. She required multiple emergency department visits for recurrent right-sided pleural effusion treated with urgent therapeutic taps. Hepatic hydrothorax is a relatively infrequent but potentially serious complication of liver cirrhosis. The management of hepatic hydrothorax, usually required in symptomatic patients, is controversial and contradictory. The case summary is followed by a question regarding available management options. The pathophysiology of hepatic hydrothorax, the role of various therapeutic options and the current favoured therapy for this not so uncommon disorder are reviewed.
Al-sharif
Hassan
H
University of Manitoba, Winnipeg, Canada.
Sharma
Sat
S
D004322:Drainage / Q000379:methods; D005260:Female; D006801:Humans; D006876:Hydrothorax / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications; D008875:Middle Aged; D010996:Pleural Effusion / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D012008:Recurrence