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Laparoscopic Left Hemihepatectomy Combined with Caudate Lobe Resection

Laparoscopic Left Hemihepatectomy Combined with Caudate Lobe Resection

Published on: April 11, 2025

Left hepatic hydrothorax without ascites.

Dorian Garin¹, Ulysse Voirol¹, Julien Vaucher^1,2

¹Division of Internal Medicine, University and Hospital of Fribourg, Fribourg, Switzerland.

BMJ Case Reports

|January 10, 2024

Summary

Hepatic hydrothorax (HH), a complication of cirrhosis, typically affects the right side and involves ascites. This report details a rare case of refractory left-sided HH without ascites, managed palliatively.

Keywords:

Cirrhosis End of life decisions (geriatric medicine)Portal hypertension

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Area of Science:

Medicine
Gastroenterology
Pulmonology

Background:

Hepatic hydrothorax (HH) is a known complication of cirrhosis with portal hypertension.
It most commonly occurs in the right pleural space and is associated with ascites.
Unilateral HH without ascites is rare, posing diagnostic and management challenges.

Observation:

This case report details a patient with refractory left unilateral hepatic hydrothorax.
The patient presented with HH without detectable ascites.
The condition was refractory to standard treatments.

Findings:

The case highlights the possibility of left-sided HH occurring in the absence of ascites.
Management involved palliative care and a semipermanent indwelling pleural catheter.
The patient survived for 3 months post-diagnosis.

Implications:

This case expands the understanding of hepatic hydrothorax presentation and localization.
It underscores the importance of considering HH even without ascites.
Palliative management with indwelling catheters can be a viable option for refractory cases.