Hepatic hydrothorax: Current concepts of pathophysiology and treatment options

Annals of Hepatology

Volumn 7, Issue 4, 2008, Pages 313-320

  Kiafar, Camron ^a   Gilani, Nooman ^a  

^a CARL T HAYDEN VA MEDICAL CENTER   (United States)

Author keywords

Complications of cirrhosis; Hepatic hydrothorax; Pleural effusions in cirrhosis

Indexed keywords

ALBUMIN; CEFOTAXIME; CEPHALOSPORIN DERIVATIVE; FUROSEMIDE; HUMAN SERUM ALBUMIN TC 99M; METHYLENE BLUE; MIDODRINE; OCTREOTIDE; SPIRONOLACTONE; TECHNETIUM SULFUR COLLOID TC 99M; TERLIPRESSIN; TETRACYCLINE;

ASCITES; CLINICAL FEATURE; CLINICAL PATHWAY; DIAPHRAGM MOVEMENT; DISEASE ACTIVITY; DISEASE ASSOCIATION; DRUG DOSE INCREASE; EMPYEMA; FLUID SHIFT; HEPATIC HYDROTHORAX; HUMAN; HYDROTHORAX; LIVER CIRRHOSIS; LIVER TRANSPLANTATION; PARACENTESIS; PATHOPHYSIOLOGY; PERITONEAL CAVITY; PERITONEUM VEIN SHUNT; PHARMACEUTICAL CARE; PLEURA CAVITY; PLEURA EFFUSION; PLEURODESIS; PNEUMOTHORAX; RADIODIAGNOSIS; REVIEW; SODIUM RESTRICTION; SPONTENEOUS BACTERIAL EMPYEMA; SURGICAL RISK; THERAPY EFFECT; THORACOCENTESIS; THORACOSCOPY; TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT; TREATMENT FAILURE; TREATMENT INDICATION; TREATMENT OUTCOME; TUBE;

EID: 56749107727     PISSN: 16652681     EISSN: None     Source Type: Journal    
DOI: 10.1016/s1665-2681(19)31831-9     Document Type: Review

References (61)

1. Morrow CS, Kantor M, Armen RN. Hepatic hydrothorax. Ann Internal Med 1958; 49: 193-203.
2. Straus RM, Boyer TD. Hepatic hydrothorax. Semin Liver Dis 1997; 17: 227-32.
3. Alberts WM, Salem AJ, Solomon DA, Boyce G. Hepatic hydrothorax, cause and management. Arch Intern Med 1991; 151: 2383-88.
4. Lieberman FL, Hidemura R, Peters RL, Reynolds TB. Pathogenesis and treatment of hydrothorax complicating cirrhosis with ascites. Ann Intern Med 1966; 64: 341-51.
5. Johnston RF, Loo RV. Hepatic hydrothorax. Studies to determine the source of the fluid and report of thirteen cases. Ann Intern Med 1964; 61: 385-401.
6. Rubinstein D, McInnes IE, Dudley FJ. Hepatic hydrothorax in the absence of clinical ascites: Diagnosis and management. Gastroenterology 1985; 88: 188-91.
7. Pop CM, Gherasim RM, Dumitrascu DL. Hydrothorax without ascites in liver cirrhosis. Rom J of Gastroenterol 2003; 12: 315-17.
8. Lazaridis KN, Frank JW, Krowka MJ, Kamath PS. Hepatic Hydrothorax: Pathogenesis, Diagnosis and Management. Am J Med 1999; 107: 262-67.
9. Emerson PA, Davies JH. Hydrothorax complicating ascites. Lancet 1955; 1: 487-88.
10. Meigs JV, Armstrong SH, Hamilton HH. A further contribution to the syndrome of fibroma of the ovary with fluid in the abdomen and chest: Meigs Syndrome. Am J Obstet Gynecol 1943; 46: 19-37.
11. Higgins G, Kelsall AR, O'Brien JRP, Stewart AM, Witts LJ. Ascites in chronic disease of the liver. Q J Med 1947; 16: 263-74.
12. Dumont AE, Mulholland JH. Flow rate and composition of thoracic duct lymph in patients with cirrhosis. N Eng J Med 1960; 263: 471-74.
13. Mouroux J, Perrin C, Venissac N, Blaive B, Richelme H. Management of pleural effusions of cirrhotic origin. Chest 1996; 109: 1093-96.
14. Huang PM, Chang YL, Yang CY, Lee YC. The morphology of diaphragmatic defects in hepatic hydrothorax: thoracoscopic finding. J Thorac Cardiovasc Surg 2005; 130: 141-45.
15. Mittal BR, Maini, A, Das BK. Peritoneopleural communication associated with cirrhotic ascites: scintigraphic demonstration. Abdom Imaging 1996; 21: 69-70.
16. Benet A, Vidal F, Toda R, Siurana R, De Virgala CM, Richart C. Diagnosis of hepatic hydrothorax in the absence of ascites by intraperitoneal injection of 99m-Tc-Fluor colloid. Postgrad Med J 1992; 68: 153.
17. Zenda T, Miyamoto S, Murata S, Mabuchi H. Detection of diaphragmatic defect as the cause of severe hepatic hydrothorax with magnetic resonance imaging. Am J Gastroenterol 1998; 93: 2288-89.
18. Nolop KB. Massive hydrothorax complicating occult cirrhosis. South Med J 1985; 78: 214-15.
19. Kaplan LM, Epstein SK, Schwartz SL, Cao QL, Pandian NG. Clinical, echocardiographic and hemodynamic evidence of cardiac tamponade caused by large pleural effusions. AM J Respir Crit Care Med 1995; 151: 904-8.
20. Xiol X, Castellote J, Cortes-Beut R, Delgado M, Guardiola J, Sese S. Usefulness and complications of thoracentesis in cirrhotic patients. Am J Med 2001; 111: 67-69.
21. McVay PA, Toy PTCY. Lack of increased bleeding after paracentesis and thoracentesis in patients with mild coagulation abnormalities. Transfusion 1991; 31: 164-71.
22. Runyon BA. Paracentesis of ascitic fluid: a safe procedure. Arch Intern Med 1986; 146: 2259-61
23. Light RW, MacGregor MI, Luchsinger PC, Ball WC. Pleural effusions: The diagnostic separation of transudates and exudates. Ann Intern Med 1972; 77: 507-13.
24. Sahn SA. State of the art: the pleura. Am Rev Respir Dis 1988; 138: 184-234.
25. Xiol X, Castellvi JM, Guardiola J, Sese E, Castellote J, Perello A, Cervantes X, et al. Spontaneous bacterial empyema in cirrhotic patients: a prospective study. Hepatology 1996; 23: 719-23.
26. Xiol X, Castellote J, Baliellas C, Ariza J, Gimenez RA, Guardiola J, Casais L. Spontaneous bacterial empyema in cirrhotic patients: Analysis of eleven cases. Hepatology 1990; 11: 365-70.
27. Albillos A, Cuervas-Mons V, Millan I, Canton T, Montes J, Barrios C, Garrido A, et al. Ascitic fluid polymorphonuclear cell count and serum to ascites albumin gradient in the diagnosis of bacterial peritonitis. Gastroenterology 1990; 98: 134-40.
28. Sese E, Xiol X, Castellote J, Rodriguez-Farinas E, Tremosa G. Low complement levels and opsonic activity in hepatic hydrothorax: its relationship with spontaneous bacterial empyema. J Clin Gastroenterol 2003; 36: 75-77.
29. Felisart J, Rimola A, Arroyo V, Perez-Ayuso RM, Quintero E, Gines P, Rodes J. Cefotaxime is more effective than is ampicillin-tobramycin in cirrhotics with severe infections. Hepatology 1985; 5: 457-62
30. Runyon BA, Akriviadis EA, Sattler FR, Cohen J. Ascitic fluid and serum cefotaxime and desacetyl cefotaxime levels in patients treated for bacterial peritonitis. Dig Dis Sci 1991; 36: 1782-86.
31. Bhattacharay A, Mittal BR, Biswas T, Dhiman RK, Singh B, Jindal SK, Chawla Y. Radioisotope scintigraphy in the diagnosis of hepatic hydrothorax. J Gastroenterol Hepatol 2001; 16: 317-21.
32. Stewart CA, Hung GL, Ackerman Z, Applebaum DM. Radionuclide determination of peritoneo-pleural communication in hydrothorax. J Nucl Med 1991; 32: 924.
33. Sawabe J, Ishida H, Niizawa M. Sonographic demonstration of diaphragmatic fistula in a patient with hepatic hydrothorax. Akita J Med 1992; 19: 615-19 (in Japanese with English translation).
34. Garcia-Tsao G. Current management of the complications of cirrhosis and portal hypertension: variceal hemorrhage, ascites, and spontaneous bacterial peritonitis. Gastroenterology 2001; 120: 726-48.
35. Garcia N Jr, Sanyal AJ. Minimizing ascites. Complications of cirrhosis signals clinical deterioration. Postgrad Med 2001; 109: 91-93.
36. Roberts LR, Kamath PS. Ascites and hepatorenal syndrome: pathophysiology and management. Mayo Clinic Proc 1996; 71: 874-81.
37. Ibrisim D, Cakaloglu Y, Akyuz F, Karadag A, Ozdil S, Besisik F, Mungan Z, et al. Treatment of hepatic hydrothorax with terlipressin in a cirrhotic patient. Scand J Gastroenterol 2006; 41: 862-65.
38. Pfammatter R, Quattropani C, Reichen J, Goke B, Wagner AC. Treatment of hepatic hydrothorax and reduction of chest tube output with octreotide. Eur J Gastroenterol Hepatol 2001; 13: 977-80.
39. Kalambokis G, Fotopoulos A, Economou M, Tsianos EV. Beneficial haemodynamic and renal sodium handling effects of combined midodrine and octreotide treatment in a cirrhotic patient with large hepatic hydrothorax and mild ascites. Nephrol Dial Transplant 2005; 20: 2583.
40. Heller BJ, Grathwohl K. Contralateral re-expansion pulmonary edema. South Med J 2000; 93: 828-31.
41. Strauss RM, Martin LG, Kaufman SL, Boyer TD. Transjugular intrahepatic portal systemic shunt for the management of symptomatic cirrhotic hydrothorax. Am J Gastroenterol 1994; 92: 1520-22.
42. Chalasani N, Gitlin N. TIPS for patients with refractory hepatic hydrothorax: what is the take home message? Am J Gastroenterol 1997; 92: 2129-30.
43. Gordon FD, Anastopoulos HT, Crenshaw W, Gilchrist B, McEnnif N, Falchuk KR, LoCicero J 3rd, et al. The successful treatment of symptomatic, refractory hepatic hydrothorax with TIPS. Hepatology 1997; 25: 1366-69.
44. Degawa M, Hamasaki K, Yano K, Nakao K, Kato Y, Sakamoto I, Nakata K, et al. Refractory hepatic hydrothorax treated with transjugular intrahepatic portosystemic shunt. J Gastroenerol 1999; 34: 128-31.
45. Conklin LD, Estrera AL, Weiner MA, Reardon PR, Reardon MJ. Transjugular intrahepatic portosystemic shunt for recurrent hepatic hydrothorax. Ann Thoracic Surg 2000; 69: 609-11.
46. Siegerstetter V, Deibert P, Ochs A, Olschewski M, Blum HE, Rossle M. Treatment of refractory hepatic hydrothorax with TIPS: long term results in 40 patients. Eur J Gastroenterol Hepatol 2001; 13: 529-34.
47. Spencer EB, Cohen DT, Darey MD. Safety and efficacy of transjugular intrahepatic portosystemic shunt creation for the treatment of hepatic hydrothorax. J Vasc Interv Radiology 2002; 13: 385-90.
48. Conn HO. Transjugular intrahepatic portal-systemic shunts: the state of the art. Hepatology 1993; 17: 148-58.
49. Wilputte JY, Goffette P, Zech F, Godoy-Gepert A, Geubel A. The outcome after transjugular intrahepatic portosystemic shunt (TIPS) for hepatic hydrothorax is closely related to liver dysfunction: a long-term study in 28 patients. Acta Gastroenterol Belg 2007; 70: 6-10.
50. Chalasani N, Clark WS, Martin LG, Kamean J, Khan MA, Patel NH, Boyer TD. Determinants of mortality in patients with advanced cirrhosis and transjugular intrahepatic portosystemic shunting. Gastroenterology 2000; 118: 138-44.
51. Falchuk KR, Jacoby I, Colucci WS, Rybak ME. Tetracycline-induced pleural symphysis for recurrent hydrothorax complicating cirrhosis. A new approach to treatment. Gastroenterology 1977; 72: 319-21.
52. Milanez de Campos Jr, Filho LO, de Campos WE, Sette H Jr, Fernandez A, Filomeno LT, Jatene FB. Thoracoscopy and talc poudrage in the management of hepatic hydrothorax. Chest 2000; 118: 13-17.
53. Ikard RW, Sawyers JL. Persistent hepatic hydrothorax after peritoneal jugular shunt. Arch Surg 1980; 115: 1125-27.
54. Drouhin F, Fischer D, Law Koune JD, Boiteau R, Tenaillon A, Labayle D. Treatment of hydrothorax in liver cirrhosis with chemical pleurodesis associated with continuous positive airway pressure ventilation. Preliminary results] Gastroenterol Clin Biol 1991; 15: 271-72
55. Takahashi K, Chin K, Sumi K, Sumi K, Nakamura T, Matsumoto H, Niimi A, et al. Resistant hepatic hydrothorax: a successful case with treatment by nCPAP. Respir Med 2005; 99: 262-64.
56. Runyon BA, Greenblatt M, Ming RHC. Hepatic hydrothorax is a relative contraindication to chest tube insertion. Am J Gastroenterol 1986; 81: 566-67.
57. Ibi T, Koizumi K, Hirata T, Mikami I, Hisayoshi T, Shimizu K. Diaphragmatic repair of two cases of hepatic hydrothorax using video-assisted thoracoscopic surgery. Gen Thorac Cardiovasc Surg 2008; 56: 229-32.
58. Ferrante D, Arguedas MR, VanLeeuwen DJ, Collins BG, van Leeuwen DJ. Video-assisted thoracoscopic surgery with talc pleurodesis in the management of symptomatic hepatic hydrothorax. Am J Gastroenterol 2002; 97: 3172-75.
59. Cerfolio RJ, Bryant AS. Efficacy of video-assisted thoracoscopic surgery with talc pleurodesis for porous diaphragm syndrome in patients with refractory hepatic hydrothorax. Ann Thorac Surg 2006; 82: 457-59.
60. Huang PM, Kuo SW, Lee JM. Thoracoscopic diaphragmatic repair for refractory hepatic hydrothorax: application of pleural flap and mesh onlay reinforcement. Thorac Cardiovasc Surg 2006; 54: 47-50.
61. Xiol X, Tremosa G, Castellote J, Gornals J, Lama C, Lopez C, Figueras J. Liver transplantation in patients with hepatic hydrothorax. Transpl Int 2005; 18: 672-75.