Treatment of Liver Cirrhosis with Hepatic Hydrothorax (Pleural Effusion)
Clinical Scenario
This protocol addresses patients with liver cirrhosis who develop hepatic hydrothorax — a pleural effusion arising as a complication of cirrhosis — in the absence of primary cardiopulmonary or primary pleural disease as an alternative explanation.
Hepatic hydrothorax is a recognised complication of liver cirrhosis in which fluid accumulates in the pleural space. This clinical scenario specifically excludes cardiopulmonary and primary pleural disease as contributing causes, placing the effusion in the context of portal hypertension and cirrhosis alone.
Management Approach (partial overview)
For recurrent or symptomatic hepatic hydrothorax in appropriately selected patients, an interventional procedure may be considered as part of the management strategy — beyond initial measures.
Full eligibility criteria, sequencing, and decision points are available in the complete protocol →
References
- Diuretics and thoracentesis are recommended as the first-line management of hepatic hydrothorax (III;1).
- In selected patients, TIPS insertion for recurrent symptomatic hepatic hydrothorax is recommended (II-2;1).
DOI: 10.1016/j.jhep.2018.03.024
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