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Hepatic hydropericardium

Ting Kin Cheung1, William Tam, Dylan Bartholomeusz

  • 1Department of Gastroenterology, Hepatology and General Medicine, Royal Adelaide Hospital, Adelaide, South Australia, Australia. cheungtingkin@yahoo.com

Journal of Gastroenterology and Hepatology
|December 17, 2003
PubMed

Insights

This case report details a patient with hepatitis C and cirrhosis who developed recurrent pericardial effusions due to a connection between abdominal ascites and the pericardial sac. Liver transplantation resolved the effusions, highlighting a rare complication of advanced liver disease.

Area of Science:

  • Cardiology
  • Hepatology
  • Gastroenterology

Background:

  • Cirrhosis, a severe form of liver disease, can lead to complex fluid-related complications.
  • Pericardial effusion, the buildup of fluid around the heart, can cause cardiac tamponade, a life-threatening condition.

Observation:

  • A patient with chronic hepatitis C and cirrhosis presented with recurrent pericardial effusions and ascites.
  • Radionuclide scans revealed a direct communication between the peritoneal and pericardial spaces.
  • Initial treatments including pericardiocentesis and pericardial window formation provided only temporary relief.

Findings:

  • The study reports the first case of pericardial effusion directly linked to cirrhotic ascites via a peritoneopericardial communication.
  • Recurrent effusions persisted despite medical management and surgical intervention, underscoring the complexity of the condition.

Implications:

  • This case highlights a rare but significant complication of advanced liver disease, emphasizing the need for considering peritoneopericardial fistulas in similar presentations.
  • Successful orthotopic liver transplantation resolved the effusions, suggesting it as a definitive treatment for this specific complication.
  • Understanding this pathway is crucial for managing complex fluid dynamics in patients with cirrhosis and ascites.

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