Abstract
Hepatic hydrothorax is defined as the presence of a significant pleural effusion that develops in a patient with cirrhosis of the liver who does not have underlying cardiac or pulmonary disease. There are few published case reports dealing with hepatic hydrothorax treated surgically because patients with hepatic hydrothorax have end-stage liver disease. Recently, we treated two patients with refractory hepatic hydrothorax by directly suturing the diaphragmatic defects during video-assisted thoracoscopic surgery (VATS). During surgery, the diaphragmatic defects were identified using abdominal insufflation of saline with indocyanine green or carbon dioxide. After suture closure using fibrin glue, both right pleural effusions were improved. The patients’ postoperative courses were uneventful, and they did not require a drainage tube when they were discharged.
Similar content being viewed by others
References
Strauss RM, Martin LG, Kaufman SL, Boyer TD. Transjugular intrahepatic portal systemic shunt for the management of symptomatic cirrhotic hydrothorax. Am J Gastroenterol 1994; 89:1520–1522.
Mouroux J, Perrin C, Venissac N, Blaive B, Richelme H. Management of pleural effusion of cirrhotic origin. Chest 1996;109: 1093–1096.
Sherman SC. Reexpansion pulmonary edema: a case report and review of the current literature. J Emerg Med 2003;24:23–27.
Gordon FD, Anastopoulos HT, Crenshaw W, Gilchrist B, McEniff N, Falchuk KR, et al. The successful treatment of symptomatic, refractory hepatic hydrothorax with transjugular intrahepatic portosystemic shunt. Hepatology 1997;25:1366–1369.
Siegerstetter V, Deibert P, Ochs A, Olschewski M, Blum HE, Rossle M. Treatment of refractory hepatic hydrothorax with transjugular intrahepatic portosystemic shunt: long-term results in 40 patients. Eur J Gastoenterol Hepatol 2001;13:529–534.
Rehse DH, Aye RW, Florence MG. Respiratory failure following talc pleurodesis. Am J Surg 1999;177:437–440.
Ferrante D, Arguedas MR, Cerfolio RJ, Collins BG, van Leeuwen DJ. Video-assisted thoracoscopic surgery with talc pleurodesis in the management of symptomatic hepatic hydrothorax. Am J Gastroenterol 2002;97:3172–3175.
Takayama T, Kurokawa Y, Kaiwa Y, Ansai M, Chiba T, Inoue T, et al. A new technique of thoracoscopic pleurodesis for refractory hepatic hydrothorax. Surg Endosc 2004;18:140–143.
Tsunezuka Y, Hatayama S, Iwase T, Watanabe G. Video-assisted thoracoscopic treatment for pleuroperitoneal communication in peritoneal dialysis. Eur J Cardiothorac Surg 2001;20:205–207.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ibi, T., Koizumi, K., Hirata, T. et al. Diaphragmatic repair of two cases of hepatic hydrothorax using video-assisted thoracoscopic surgery. Gen Thorac Cardiovasc Surg 56, 229–232 (2008). https://doi.org/10.1007/s11748-007-0221-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11748-007-0221-8