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Transjugular intrahepatic portosystemic shunt for recurrent hepatic hydrothorax
Ist Teil von
The Annals of thoracic surgery, 2000-02, Vol.69 (2), p.609-611
Ort / Verlag
New York, NY: Elsevier Inc
Erscheinungsjahr
2000
Quelle
MEDLINE
Beschreibungen/Notizen
For many years, pleural effusions have been recognized as a complication of cirrhosis, occurring in approximately 5.5% of patients. Recent studies have confirmed that small defects in the diaphragm allow for passage of ascitic fluid into the pleural space. Successful management of these patients is challenging, as many of the treatment options can be associated with increased morbidity. The initial treatment should focus on eliminating and preventing the recurrence of ascites with diuretics and water and salt restriction. For those patients who do not respond medically, more invasive techniques have been used including serial thoracentesis, chest tube placement, chemical pleurodesis, and peritoneovenous shunts. We present a patient with recurrent pleural effusions secondary to hepatic cirrhosis who was unsuccessfully treated medically, and subsequently treated with thoracentesis, chest tube drainage and pleurodesis, with ultimate resolution after transjugular intrahepatic portosystemic shunt placement.