Hepatic Hydrothorax
Hepatic Hydrothorax
63 year-old female with biopsy- proven cirrhosis secondary to alpha-1-antitrypsin deficiency complained of shortness of breath and cough productive of scant amounts of mucoid phlegm for 1 week
• 63 year-old female with biopsyproven cirrhosis secondary to alpha-1-antitrypsin deficiency complained of shortness of breath and cough productive of scant amounts of mucoid phlegm for 1 week
She denied fevers or chills.In the post,she had undergone a total abdominal hysterectomy and radiation therapy for uterine cancer as well as a sigmoid resection for radiation colitis
• She denied fevers or chills. In the post, she had undergone a total abdominal hysterectomy and radiation therapy for uterine cancer as well as a sigmoid resection for radiation colitis
Follow up evaluations had not shown signs of cancer recurrence
• Follow up evaluations had not shown signs of cancer recurrence
She did not smoke or drink alcoholic beverages
• She did not smoke or drink alcoholic beverages
On physical examination,she appeared in moderate respiratory distress.The right hemithorax was dull to percussion and the vocal fremitus was markedly diminished. Shifting dullness was present on abdominal exam
• On physical examination, she appeared in moderate respiratory distress. The right hemithorax was dull to percussion and the vocal fremitus was markedly diminished. Shifting dullness was present on abdominal exam
She had 2+pitting edema up to her shins bilaterally
• She had 2+ pitting edema up to her shins bilaterally
A chest X-ray revealed a large right pleural effusion
• A chest X-ray revealed a large right pleural effusion
The combination of ascites and right-sided pleural effusion in a patient with cirrhosis raised the possibility of a hepatic hydrothorax
• The combination of ascites and right-sided pleural effusion in a patient with cirrhosis raised the possibility of a hepatic hydrothorax