Hepatic hydrothorax

Karen Krok, Andrés Cárdenas

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Hepatic hydrothorax is defined as a transudative pleural effusion, usually greater than 500 mL, in patients with portal hypertension without any other underlying primary cardiopulmonary cause. It develops most likely because of diaphragmatic defects that allow for passage of fluid from the peritoneal space to the pleural space. Because of the mechanical constraints of the thoracic cavity, this complication of portal hypertension can be challenging to treat because patients will become symptomatic when as little as 500 mL of fluid is present in the pleural space. Treatments include salt restriction, diuretics, thoracentesis, transjugular intrahepatic portosystemic shunt, video-assisted thoracoscopy, and pleurodesis. It is important to note that a chest tube is not a potential treatment option; a hepatic hydrothorax should not be treated with a chest tube unless there is frank pus in the pleural fluid or a pneumothorax is present. The ultimate treatment is a liver transplant; the development of a hepatic hydrothorax thus warrants a referral to a liver transplant center.

Original languageEnglish (US)
Pages (from-to)3-10
Number of pages8
JournalSeminars in Respiratory and Critical Care Medicine
Volume33
Issue number1
DOIs
StatePublished - Mar 23 2012

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Hydrothorax
Liver
Chest Tubes
Portal Hypertension
Pleurodesis
Transjugular Intrahepatic Portasystemic Shunt
Thoracic Cavity
Transplants
Thoracoscopy
Suppuration
Ascitic Fluid
Pneumothorax
Pleural Effusion
Diuretics
Therapeutics
Referral and Consultation
Salts

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Krok, Karen ; Cárdenas, Andrés. / Hepatic hydrothorax. In: Seminars in Respiratory and Critical Care Medicine. 2012 ; Vol. 33, No. 1. pp. 3-10.
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Hepatic hydrothorax. / Krok, Karen; Cárdenas, Andrés.

In: Seminars in Respiratory and Critical Care Medicine, Vol. 33, No. 1, 23.03.2012, p. 3-10.

Research output: Contribution to journalArticle

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AB - Hepatic hydrothorax is defined as a transudative pleural effusion, usually greater than 500 mL, in patients with portal hypertension without any other underlying primary cardiopulmonary cause. It develops most likely because of diaphragmatic defects that allow for passage of fluid from the peritoneal space to the pleural space. Because of the mechanical constraints of the thoracic cavity, this complication of portal hypertension can be challenging to treat because patients will become symptomatic when as little as 500 mL of fluid is present in the pleural space. Treatments include salt restriction, diuretics, thoracentesis, transjugular intrahepatic portosystemic shunt, video-assisted thoracoscopy, and pleurodesis. It is important to note that a chest tube is not a potential treatment option; a hepatic hydrothorax should not be treated with a chest tube unless there is frank pus in the pleural fluid or a pneumothorax is present. The ultimate treatment is a liver transplant; the development of a hepatic hydrothorax thus warrants a referral to a liver transplant center.

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