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J Thorac Cardiovasc Surg 2008;136:1367-1369
© 2008 The American Association for Thoracic Surgery

Brief Communication

Long-term remission of hepatic hydrothorax after OK-432 pleurodesis

Pei-Ying Lin, MD, Ping-Hung Kuo, MD*, Chong-Jen Yu, MD, PhD, Pan-Chyr Yang, MD, PhD

Division of Chest Medicine, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan

Received for publication October 15, 2007; accepted for publication December 2, 2007.

* Address for reprints: Ping-Hung Kuo, MD, Division of Chest Medicine, Department of Internal Medicine, National Taiwan University Hospital No. 7, Chung-Shan S Rd, Taipei 100, Taiwan. (Email: Kph712@ntuh.gov.tw).

The first 20% of the full text of this article appears below.

Hepatic hydrothorax, a manifestation of end-stage liver disease, is defined as the presence of more than 500 mL of pleural effusion in patients with liver cirrhosis who do not have cardiopulmonary diseases or malignancies that could explain this effusion.1Go Strauss and Boyer2Go have reported incidences of 85.4 right-sided, 12.5% left-sided, and 2% bilateral hepatic hydrothoraces. The most likely cause is fluid transfer from the abdomen to the pleural space through diaphragmatic defects.1Go Optimal management remains unclear, and thoracocentesis is frequently required for immediate symptom relief. Alternative treatments, including pleurodesis by tube thoracostomy or video-assisted thoracoscopic surgery (VATS), diaphragm repair, transjugular intrahepatic portosystemic shunt, peritoneovenous shunts, or liver transplantation, should be considered when frequent therapeutic thoracocentesis is needed.1Go We report here the first case of refractory hepatic hydrothorax in which a 5-year remission was achieved by nonsurgical OK-432 pleurodesis.

Clinical Summary

A 78-year-old woman with hepatitis C–related Child–Pugh class C liver cirrhosis came to our hospital with new-onset dyspnea and bilateral lower leg pitting edema. There was a history of refractory right-sided hepatic hydrothorax 5 years . . . [Full Text of this Article]






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