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Intractable Hepatic Hydrothorax: A Successful Outcome following CPAP Treatment
Hassene Attout1, Khalil J F Samaan2, Hichem Bouhamla1
1Internal Medicine Department, Les Cevennes Hospital, Ales, France.
European Journal of Case Reports in Internal Medicine
|November 23, 2022
Summary
Hepatic hydrothorax, a complication of advanced liver disease, can be challenging to treat. Continuous positive airway pressure (CPAP) therapy showed significant improvement in pleural effusion for a patient with refractory hepatic hydrothorax.
Area of Science:
- Hepatology
- Pulmonology
- Critical Care Medicine
Background:
- Hepatic hydrothorax is an infrequent but serious complication of end-stage liver disease.
- It can lead to respiratory distress, hypoxia, infection, and a poor prognosis.
- Standard treatments include dietary sodium restriction and diuretics.
Purpose of the Study:
- To describe a case of refractory hepatic hydrothorax in a patient with decompensated liver cirrhosis.
- To evaluate the efficacy of continuous positive airway pressure (CPAP) as a treatment modality.
Main Methods:
- Case report of an 80-year-old woman with NASH-related decompensated liver cirrhosis.
- Treatment with CPAP for refractory hepatic hydrothorax.
Main Results:
- The patient presented with refractory hepatic hydrothorax.
- CPAP therapy resulted in marked improvement of pleural effusion.
Conclusions:
- Hepatic hydrothorax affects 4-6% of cirrhosis patients and up to 10% of decompensated cirrhosis patients.
- It can be refractory to conventional treatments like diuretics and salt restriction.
- CPAP presents a potential alternative treatment option for refractory hepatic hydrothorax.
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