title: Hepatic hydrothorax.
abstract: Hepatic hydrothorax (HH) is an uncommon complication in patients with end-stage liver disease. Only 5% to 10% of patients with end-stage liver disease develop HH, which may result in dyspnea, hypoxia, and infection, and portends a poor prognosis. The most likely explanation for development is passage of fluid from the peritoneal space to the pleural space due to small diaphragmatic defects. Initial management consists of diuretics with dietary sodium restriction and thoracentesis, and a transjugular intrahepatic portosystemic shunt may ultimately be required. Afflicted patients can develop morbid and fatal complications, pose management dilemmas, and should warrant evaluation for liver transplantation.
authors.affiliation: Division of Digestive Diseases, Department of Digestive Diseases, Department of Medicine, Emory Transplant Center, Emory University, 1365 Clifton Road, NE, Clinic B, Suite 1200, Atlanta, GA 30322, USA. Electronic address: jpnorvell@emory.edu.
authors.forename: John Paul
authors.initials: JP
authors.lastname: Norvell
authors.affiliation: Division of Digestive Diseases, Department of Digestive Diseases, Department of Medicine, Emory Transplant Center, Emory University, 1365 Clifton Road, NE, Clinic B, Suite 1200, Atlanta, GA 30322, USA.
authors.forename: James R
authors.initials: JR
authors.lastname: Spivey
mesh_terms: D001424:Bacterial Infections / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D004322:Drainage; D016724:Empyema, Pleural / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006801:Humans; D006876:Hydrothorax / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006975:Hypertension, Portal / Q000150:complications*; D016031:Liver Transplantation; D018700:Pleurodesis; D019168:Portasystemic Shunt, Transjugular Intrahepatic
keywords: Cirrhosis; Hepatic hydrothorax; Spontaneous bacterial empyema; Thoracentesis; Transjugular intrahepatic portosystemic shunt