Hepatic hydrothorax (HH) is an uncommon manifestation of cirrhosis with ascites. It is one of the pulmonary complications of cirrhosis with portal hypertension.
It is characterized by formation of pleural effusions usually greater than 500 mL, in patients with portal hypertension without any other underlying primary cardiopulmonary cause .
Its estimated prevalence among cirrhotic patients is ~5-10% .
It is thought to occur when ascitic fluid moves through diaphragmatic defects that have been opened by increased peritoneal pressure.
The ascitic fluid can be infected, so the patient can develop spontaneous bacterial pleuritis (SBPL).
The diagnosis is established clinically by finding a serous transudate and it is confirmed by radionuclide imaging demonstrating communication between the peritoneal and pleural spaces and by pleural fluid analysis.
- right: 73-85%
- left: 13-17%
- bilateral: 2-10%