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  • Title: Hepatic hydrothorax: pathogenesis, diagnosis, and management.
    Author: Lazaridis KN, Frank JW, Krowka MJ, Kamath PS.
    Journal: Am J Med; 1999 Sep; 107(3):262-7. PubMed ID: 10492320.
    Abstract:
    Hepatic 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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