[Right hydrothorax associated with portal cavernoma in the absence of hepatic cirrhosis].
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The patient and spouse were able to successfully complete their CAPD training program and meet established parameters. The diaphragmatic leak precluded the patient from maintaining fluid volume status within our guidelines. Through the efforts and intervention by our nursing staff and renal social worker, the patient was able to demonstrate positive coping strategies when dealing with this difficult situation. Maintaining fluid and electrolyte balance was eventually achieved though hemodialysis. The patient did not agree to having pleural sclerotherapy and, therefore, she remains on chronic hemodialysis.
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Two patients with cirrhosis and ascites complicated by extensive unilateral pleural transudates refractory to therapy with dietary sodium restriction, diuretics, and repeated thoracentesis were successfully managed by tetracycline-induced pleural symphysis. The intrapleural instillation of this antibiotic prevented the recurrence of the effusion and substantially relieved the patients' symptoms with minimal undesirable side effects.
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