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Published on: June 18, 2020
Refractory Hepatic Hydrothorax in the Absence of Ascites as a First Sign of Cirrhosis
Khalil Aloreidi1, Maheedhar Gedela1, Godfrey Wabwire2
1Department of Internal Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota.
Abstract:
Hepatic hydrothorax (HH) occurs in 5-10 percent of patients with cirrhosis and usually develops in conjunction with ascites. We report a case of refractory right sided pleural effusion which turned out to be HH in the absence of ascites or previous history of cirrhosis. HH is thought to occur in isolation due to the superior absorptive capacity of the peritoneum as compared to the pleura. Diagnosis is usually clinical but can be confirmed by scintigraphic studies. The treatment is similar to that for ascites with transjugular intrahepatic portosystemic shunt (TIPS) being the most effective but it is associated with high rate of complications.
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