A case of intractable hepatic hydrothorax treated by pleuro-venous shunt

Abstract

A 67-year-old woman with type C liver cirrhosis was hospitalized to our hospital for hepatic ascites and pleural effusion. Ascites improved with diuretics, but pleural effusion was intractable. Chest-X-ray films showed a massive pleural effusion in right hemithorax. The patient suffered from dyspnea in spite of repeated thoracentesis. A pleuro-venous shunt was inserted. Initially, pleural effusion was unchangeable, but subsequently decreased by increasing pumping times and mandatory thoracentesis. Finally, pleural effusion resolved and symptoms improved. Chest-X-ray films showed a full expansion of right lung and a few pleural effusion. Pleuro-venous shunting may provide satisfactory palliation and improve quality of life for intractable hepatic pleural effusions.