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Hepatic hydrothorax: pathogenesis, diagnosis, and management
K N Lazaridis1, J W Frank, M J Krowka
1Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA.
The American Journal of Medicine
|September 24, 1999
Summary
Hepatic hydrothorax, a pleural effusion in cirrhosis patients, affects 4-10% of cases. Management includes diuretics and shunts, with liver transplant as a final option for this liver disease complication.
Area of Science:
- Hepatology
- Pulmonology
- Gastroenterology
Background:
- Hepatic hydrothorax is a serious complication of liver cirrhosis.
- It presents as pleural effusion without other cardiopulmonary causes.
- Affecting 4-10% of cirrhosis patients, it significantly impacts quality of life.
Purpose of the Study:
- To define hepatic hydrothorax.
- To outline its pathophysiology.
- To review current and potential management strategies.
Main Methods:
- Literature review of hepatic hydrothorax.
- Analysis of pathophysiology involving diaphragmatic defects.
- Summary of clinical management approaches.
Main Results:
- Hepatic hydrothorax results from ascitic fluid translocation into the pleural space.
- Diaphragmatic defects facilitate fluid movement.
- Increased risk of respiratory infections is a key concern.
Conclusions:
- Initial management involves sodium restriction, diuretics, and thoracentesis.
- Transjugular intrahepatic portosystemic shunt (TIPS) may be necessary.
- Liver transplantation is a consideration for end-stage liver disease patients unresponsive to other treatments.