Treatment of Liver Cirrhosis with Hepatic Hydrothorax (Pleural Effusion)

This protocol applies to patients with liver cirrhosis who have developed hepatic hydrothorax — pleural effusion arising as a direct complication of cirrhotic liver disease — where cardiopulmonary and primary pleural disease have been excluded as contributing causes.

Hepatic hydrothorax is pleural fluid accumulation in the context of portal hypertension. This protocol is specific to cases where the effusion is of hepatic origin: cardiopulmonary disease and primary pleural pathology are both absent, confirming the cirrhotic aetiology.

First-line management involves a combination of diuretic therapy and thoracentesis. Thoracentesis has a specific role in patients with breathlessness. The full protocol details the complete clinical algorithm, indications, and sequencing — access it below.