Hepatic hydrothorax.

John Paul Norvell, James R Spivey

Journal: Clinics in liver disease 2015;18(2):439-49

PMID: 24679505

Full Text on Elsevier Science View on PubMed

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.

Address: 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: [email protected].; 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.

DOI: 10.1016/j.cld.2014.01.005

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MeSH Terms: Bacterial Infections, Drainage, Empyema, Pleural, Humans, Hydrothorax, Hypertension, Portal, Liver Transplantation, Pleurodesis, Portasystemic Shunt, Transjugular Intrahepatic