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Related Experiment Videos

Hepatic hydrothorax.

X Xiol1, J Guardiola

  • 1Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.

Current Opinion in Pulmonary Medicine
|May 17, 2000
PubMed
Summary
This summary is machine-generated.

Refractory hepatic hydrothorax (fluid in the pleural space) management is challenging. Videothoracoscopy and transjugular intrahepatic portosystemic shunts show promise for treating this condition.

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Area of Science:

  • Hepatology
  • Pulmonology
  • Interventional Gastroenterology

Background:

  • Hepatic hydrothorax involves ascitic fluid in the pleural space, typically managed with standard ascites treatments.
  • Refractory hepatic hydrothorax lacks established treatment guidelines when initial measures fail.

Purpose of the Study:

  • To review current and emerging therapeutic strategies for refractory hepatic hydrothorax.
  • To highlight the efficacy and adverse effects of videothoracoscopy and transjugular intrahepatic portosystemic shunts.
  • To discuss the implications of spontaneous bacterial empyema and liver transplantation.

Main Methods:

  • Review of literature on hepatic hydrothorax management.
  • Analysis of videothoracoscopy for diaphragmatic defect closure and pleurodesis.

Related Experiment Videos

  • Evaluation of transjugular intrahepatic portosystemic shunt (TIPS) efficacy and complications.
  • Discussion of spontaneous bacterial empyema (SBE) incidence and diagnosis.
  • Consideration of liver transplantation as a treatment option.

    • Main Results:

    • Videothoracoscopy with pleurodesis achieved long-lasting control in 6/8 patients with low morbidity.
    • Transjugular intrahepatic portosystemic shunt effectively treated over 75% of refractory cases, with risks including hepatic encephalopathy.
    • Spontaneous bacterial empyema occurred in 13% of patients, sometimes without concurrent spontaneous bacterial peritonitis.
    • Bedside inoculation of pleural fluid into blood culture bottles enhances diagnostic sensitivity for SBE.

    Conclusions:

    • Videothoracoscopy and TIPS are viable options for refractory hepatic hydrothorax.
    • Prompt diagnosis and management of spontaneous bacterial empyema are crucial.
    • Patients with refractory hepatic hydrothorax or SBE should be evaluated for liver transplantation.