Direct intrahepatic portocaval shunt for refractory hepatic hydrothorax: a case report

10. Barreales

We report the case of a patient that developed hepatic hydrothorax as the first complication of liver cirrhosis. Due to the lack of response to diuretics, pleurodesis and TIPS, treatment with octreotide was started with resolution of hydrothorax. To the best of our knowledge, this is the third reported case of refractory hepatic hydrothorax with complete and sustained response to octreotide.

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

Hepatic hydrothorax in the absence of ascites is a rare complication of liver cirrhosis. A 71-year-old man with liver cirrhosis due to alcohol abuse was referred to our department because of massive pleural effusion on the right side. The properties of pleural effusion and clinical course led to a diagnosis of hepatic hydrothorax. Nonsurgical OK-432 pleurodesis resulted in a marked decrease of ...

Complete Remission of Refractory Hepatic Hydrothorax in Patient with Advanced Liver Cirrhosis and Hepatocellular Carcinoma Using Transjugular Intrahepatic Portosystemic Shunt

Hepatic hydrothorax is defined as the presence of pleural fluid (>500 mL) in the absence of primary cardiac or pulmonary disease. Initial treatments consist of a low salt diet, diuretics, and thoracentesis. If these are not effective, other modalities should be considered. The transjugular intrahepatic portosystemic shunt (TIPS) placement is one of the modalities for treatment of hepatic hydrot...

Transjugular Intrahepatic Portosystemic Shunt as the Treatment for Refractory Hepatic Hydrothorax with Portal Vein Thrombosis

Hemobilia Secondary to Transjugular Intrahepatic Portosystemic Shunt Procedure: A Case Report

A 59 year-old woman with liver cirrhosis due to hepatitis C, complicated by refractory hepatic hydrothorax was treated with a TIPS (transjugular intrahepatic portosystemic shunt) procedure. The procedure was complicated by substantial gastrointestinal hemorrhage. EGD (esophagogastroduodenoscopy) was performed and revealed hemobilia. A hepatic angiogram was then performed revealing a fistulous t...