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J Thorac Cardiovasc Surg 2009;138:1251-1252
© 2009 The American Association for Thoracic Surgery

Brief Research Report

Color Doppler ultrasonography in detecting transdiaphragmatic flow of hepatic hydrothorax: Correlation with thoracoscopic findings

Department of Traumatology and Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

Received for publication April 3, 2008; accepted for publication April 16, 2008.

^_* Address for reprints: Yung-Chie Lee, MD, PhD, Division of Thoracic Surgery, Department of Surgery and Traumatology, National Taiwan University Hospital, No. 7, Chung-Shan S Rd, Taipei 100, Taiwan. (Email: yclee@ntuh.gov.tw).

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

	Introduction

 
Many mechanisms have been proposed for hepatic hydrothorax (HH), pleural effusion seen in cirrhotic patients, and the transdiaphragmatic flow of ascitic fluid through the diaphragmatic defects is considered the most probable.^1,2 There are several methods for diagnosis of HH, including biochemical analysis of ascitic and pleural fluids, conventional radiography, radioisotopic imaging, magnetic resonance imaging, and thoracoscopy. Among these, ultrasonography may be considered the easiest method and has the benefit of real-time diagnosis of anatomic integrity. On the other hand, the magnification offered by the optical system of thoracoscopy allows excellent localization of diaphragmatic defects. This study is the first demonstration of the transdiaphragmatic flow by color Doppler ultrasonography that further directly verifies detected defects by means of video-assisted thoracoscopic surgery.

	Materials and Methods

 
Between January 2005 and August 2007, a total of 9 patients with cirrhosis and refractory pleural effusion (4 male and 5 female; mean age, 59 years; range, 41–81 years) were evaluated to determine the communication of fluid . . . [Full Text of this Article]