Intractable Hepatic Hydrothorax: A Successful Outcome following CPAP Treatment

Hassene Attout; Khalil J F Samaan; Hichem Bouhamla; Sofia Amichi; Kamel Dahmani

doi:10.12890/2022_003610

Intractable Hepatic Hydrothorax: A Successful Outcome following CPAP Treatment

Eur J Case Rep Intern Med. 2022 Oct 10;9(10):003610. doi: 10.12890/2022_003610. eCollection 2022.

Authors

Hassene Attout¹, Khalil J F Samaan², Hichem Bouhamla¹, Sofia Amichi¹, Kamel Dahmani²

Affiliations

¹ Internal Medicine Department, Les Cevennes Hospital, Ales, France.
² Department of Respiratory Medicine, Les Cevennes Hospital, Ales, France.

Abstract

Hepatic hydrothorax is an uncommon complication in patients with end-stage liver disease. It may result in dyspnoea, hypoxia and infection, and carries a poor prognosis. Initial treatment is based on a sodium-free diet together with diuretics. In case of recurrent hydrothorax, a transjugular intrahepatic portosystemic shunt (TIPS) or liver transplant should be considered. Here we describe an 80-year-old woman with decompensated liver cirrhosis related to NASH who presented with refractory hepatic hydrothorax. Treatment with CPAP resulted in a marked improvement in her pleural effusion.

Learning points: Hydrothorax is uncommon, occurring in up to 4-6% of all patients with cirrhosis and in up to 10% of patients with decompensated cirrhosis.Hepatic hydrothorax can be refractory to diuretics and salt restriction.CPAP may be an interesting alternative treatment.

Keywords: CPAP; Cirrhosis; hepatic hydrothorax.