Liver Cirrhosis Patient with Complications of Hepatic Hydrothorax. Case Report

Abstract

Introduction: Hepatic hydrothorax is that occurs in individuals with decompensated cirrhosis of the liver. Approximately 5 % of cases of pleural effusion occur in patients with cirrhosis and ascites. Although quite rare, it is associated with higher morbidity and lower survival rates. The mechanism is not fully understood, but the most widely accepted pathogenesis involves the presence of portal hypertension, diaphragmatic defects, and negative intrathoracic pressure. In this case, the pleural effusion occurs because of the direct displacement of peritoneal fluid through the small openings in the diaphragm into the pleural space. We aimed to study its clinical features and natural history. Case Presentation: We reported a 59-year-old woman with liver cirrhosis and hepatic hydrothorax complications. Patients experience shortness of breath and hematemesis. Examination of chest X-ray and chest CT scan found right pleural effusion. The patient was treated with repeated thoracocentesis, and a chest pigtail catheter was placed for pleural effusion, salt restriction, diuretics, and management of the underlying disease (liver cirrhosis). After the installation of the chest pigtail catheter, the fluid production reduced (less than 500 mL in a day). The results of the pleural fluid analysis showed an impression of the transudate. Conclusion: This study reports the rare case of a patient with right pleural effusion due to hepatic hydrothorax in liver cirrhosis, who improved with comprehensive therapy (salt restriction, diuretics, repeated thoracocentesis, and then chest pigtail catheter application).