• K N Lazaridis, J W Frank, M J Krowka, and P S Kamath.
• Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA.
• Am. J. Med. 1999 Sep 1;107(3):262-7.

AbstractHepatic hydrothorax is defined as a pleural effusion in a patient with cirrhosis of the liver and no cardiopulmonary disease. The estimated prevalence of this often debilitating complication in patients with liver cirrhosis is 4% to 10%. Its pathophysiology involves movement of ascitic fluid from the peritoneal cavity into the pleural space through diaphragmatic defects. As a result patients are at increased risk of respiratory infection. Initial management consists of sodium restriction, diuretics, and thoracentesis. A transjugular intrahepatic portosystemic shunt may be required. Because most patients with hepatic hydrothorax have end-stage liver disease, a liver transplant should be considered if these options fail.

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