Unilateral pleural effusion without clinical ascites in Laennec's cirrhosis

Llaneza, Pedro P.; Salt, William B.

doi:10.1007/bf01318377

Cited by 17 publications

(5 citation statements)

References 21 publications

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“…19 It is well known that hepatic hydrothorax may occasionally occur in the absence of ascites. [20][21][22][23] Recent studies using intraabdominally-injected, radiolabeled colloids and/or radioactive isotope scans confirmed the communication between the peritoneal cavity and the pleural space in these cases. 21,24 Moreover, ultrasonography showed a large defect in the right hemidiaphragm of a patient with hepatic hydrothorax and no evidence of ascites.…”

Section: Pathogenesismentioning

confidence: 74%

“…It is well known that hepatic hydrothorax may occasionally occur in the absence of ascites 20–23 . Recent studies using intra‐abdominally‐injected, radiolabeled colloids and/or radioactive isotope scans confirmed the communication between the peritoneal cavity and the pleural space in these cases 21,24 .…”

Section: Pathogenesismentioning

confidence: 93%

“…Several authors have reported cases of unilateral pleural effusions in cirrhotic patients without clinical or even ultrasonic evidence of ascites. [20][21][22][23] In these cases, respiratory symptoms may confuse the clinician leading to an extensive diagnostic evaluation, as liver cirrhosis is not commonly considered a distinct cause of pleural effusion.…”

Section: Clinical Presentation and Diagnosismentioning

confidence: 99%

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Hepatic hydrothorax: Pathophysiology diagnosis and management

Roussos

Philippou

Mantzaris

et al. 2007

J of Gastro and Hepatol

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Hepatic hydrothorax is defined as a significant pleural effusion (usually greater than 500 ml) in a cirrhotic patient, without an underlying pulmonary or cardiac disease. The diagnosis of hepatic hydrothorax should be suspected in a patient with established cirrhosis and portal hypertension, presenting with a unilateral pleural effusion, most commonly right-sided. In the vast majority of cases, patients with hepatic hydrothorax have end-stage liver disease. Therefore, they should be considered potential candidates for orthotopic liver transplantation. Until the performance of transplantation, other therapeutic modalities should be applied in order to relieve symptoms and prevent pulmonary complications.

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Section: Pathogenesismentioning

confidence: 74%

Section: Pathogenesismentioning

confidence: 93%

Section: Clinical Presentation and Diagnosismentioning

confidence: 99%

See 1 more Smart Citation

Hepatic hydrothorax: Pathophysiology diagnosis and management

Roussos

Philippou

Mantzaris

et al. 2007

J of Gastro and Hepatol

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“…Hepatic hydrothorax is defined as the accumulation of significant pleural effusion (usually4 500 ml) in a cirrhotic patient without primary pulmonary or cardiac disease (1). Although ascites is usually present in these patients, significant pleural effusion may develop in patients without ascites (2)(3)(4)(5)(6). The pleural effusion is usually right sided (67-85% of cases) but may be bilateral or left sided (7)(8)(9).…”

mentioning

confidence: 99%

Hepatic hydrothorax – pathophysiology, diagnosis and treatment – review of the literature

Gur

Ilan

Shibolet

2004

Liver International

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Hepatic hydrothorax is defined as the accumulation of significant pleural effusion in a cirrhotic patient without primary pulmonary or cardiac disease. Hydrothorax is uncommon occurring in up to 4-6% of all patients with cirrhosis and up to 10% in patients with decompensated cirrhosis. Although ascites is usually present, hydrothorax can occur in the absence of ascites. Patients with hepatic hydrothorax usually have advanced liver disease with portal hypertension and most of them will require liver transplantation. Over the last few years, new insights into the pathogenesis of this entity have lead to improved treatment modalities such as portosystemic shunts (TIPS) and video-assisted thoracoscopy for closure of diaphragmatic defects. These modalities may be of help as a bridge to transplantation. The aim of this review is to describe recent developments in the pathogenesis, diagnosis and treatment of hepatic hydrothorax.

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“…The diagnosis of a hepatic hydrothorax can usually be made clinically in the presence of ascites and a significant transudative (usually right-sided) pleural effusion. However, there have been multiple case reports of hydrothorax without ascites [4][5][6][7][8][9]. A relatively simple test to establish whether there is a communication between the two cavities is to inject a radiotracer into the peritoneum; radioactivity in the thorax is specific to a hepatic hydrothorax [5].…”

Section: Discussionmentioning

confidence: 99%