[Thoracoscopic repair of peritoneopleual communication with a giant diaphragmatic bullae in a patient with liver cirrhosis; report of a case].
Hepatic hydrothorax is defined as pleural effusion in patients with a cirrhotic liver. The pleural effusion occurs due to ascites flowing to the pleural cavity through a diaphragmatic communication. Recent literature has described the usefulness of a thoracoscopic repair and has shown that it can control pleural effusion very efficaciously. The patient was a 65-year-old woman who complained of dyspnea and was admitted to our hospital. A chest X-ray revealed marked right pleural effusion. We injected indigo carmine intraperitoneally and observed indigo carmine-colored pleural effusion; thus peritoneopleural communication was validated. After the failure of thoracic drainage and pleurodesis with minocycline hydrochloride, thoracoscopic surgery was performed 5 weeks after hospitalization. Obvious bulla formation was observed on the diaphragm, which was immediately resected with linear staplers. The postoperative course was excellent without any recurrence of pleural effusion.
Yamane
M
M
Department of Cardiovascular Surgery, Mitoyo General Hospital, Kannon-ji, Japan.
Kobayashi
S
S
Kurosaki
A
A
Nanki
N
N
Ando
M
M
Maeda
H
H
D000368:Aged; D003560:Cysts / Q000601:surgery; D003964:Diaphragm / Q000002:abnormalities / Q000601:surgery; D005260:Female; D005402:Fistula / Q000601:surgery*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D010532:Peritoneal Diseases / Q000601:surgery*; D010995:Pleural Diseases / Q000601:surgery*; D010996:Pleural Effusion / Q000209:etiology / Q000601:surgery*; D013906:Thoracoscopy