Global InformationHepatic hydrothorax information
| Hepatic hydrothorax | |
|---|---|
 | |
| Chest X-ray showing a hepatic hydrothorax in a person with cirrhosis | |
| Symptoms | Cough, shortness of breath, and respiratory failure |
| Causes | Liver cirrhosis, ascites |
| Diagnostic method | Pleural fluid analysis |
| Treatment | Medical management, thoracentesis, liver transplant, palliative care |
| Prognosis | Poor |
Hepatic hydrothorax is a rare form of pleural effusion that occurs in people with liver cirrhosis. It is defined as an effusion of over 500 mL in people with liver cirrhosis that is not caused by heart, lung, or pleural disease. It is found in 5–10% of people with liver cirrhosis and 2–3% of people with pleural effusions. In cases of decompensated liver cirrhosis, prevalence rises significantly up to 90%.[1] Over 85% of cases occurring on the right, 13% on the left, and 2% on both.[2] Although it is most common in people with severe ascites, it can also occur in people with mild or no ascites. Symptoms are not specific and mostly involve the respiratory system.
The condition is diagnosed based on the existence of liver cirrhosis and fluid build-up in the abdomen (ascites) and analysis of the fluid. The fluid has a low protein content. Mainly, the condition is treated by medical management, such as diet adjustment and usage of diuretics. When the condition does not respond, it is known as refractory hepatic hydrothorax: treatment includes inserting a transjugular intrahepatic portosystemic shunt (TIPS). The only curative treatment is a liver transplant. The prognosis is usually unfavorable, especially in refractory cases, due to the majority of people being unsuitable for transplantation.[3] However, transplantation indicates a favorable prognosis; one case study showed that the condition had no effect on post-transplant outcomes.[1]
- ^ a b Wilkins, Hannah; Britt, Ellie; Bhatnagar, Malvika; Pippard, Benjamin (2024-02-29). "Hepatic hydrothorax". Journal of Thoracic Disease. 16 (2): 1662–1673. doi:10.21037/jtd-23-1649. ISSN 2072-1439. PMC 10944768. PMID 38505059.
- ^ Garbuzenko, Dmitry Victorovich; Arefyev, Nikolay Olegovich (2017-11-08). "Hepatic hydrothorax: An update and review of the literature". World Journal of Hepatology. 9 (31): 1197–1204. doi:10.4254/wjh.v9.i31.1197. ISSN 1948-5182. PMC 5680207. PMID 29152039.
- ^ Ditah, Ivo C; Al Bawardy, Badr F; Saberi, Behnam; Ditah, Chobufo; Kamath, Patrick S (2015-07-08). "Transjugular intrahepatic portosystemic stent shunt for medically refractory hepatic hydrothorax: A systematic review and cumulative meta-analysis". World Journal of Hepatology. 7 (13): 1797–1806. doi:10.4254/wjh.v7.i13.1797. ISSN 1948-5182. PMC 4491909. PMID 26167253.