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PubMed1999

Delayed pneumothorax and hydrothorax with central venous catheter migration.

We report a case of delayed pneumothorax, central venous catheter migration and iatrogenic hydrothorax in a 22-year-old female. The left subclavian central venous catheter initially transfixed the lung apex; pneumothorax occurred 24 h later following initiation of positive pressure ventilation. Lung collapse as a result of the pneumothorax caused catheter migration and hydrothorax. Catheter removal and chest drainage led to an uneventful recovery.

Adult↗

PubMedDate not supplied

[Fetal hydrothorax].

Three cases of bilateral congenital hydrothorax concomitant with hydrops fetalis are presented and compared with similar cases in literature. The hydrops fetalis to our opinion is caused by peripheral hypoxia. The hypoxia has its origin in the restricted cardiac output caused by the bilateral hydrothorax.

Amniocentesis↗

PubMed1990

Hepatic hydrothorax: report of two cases.

This paper describes two patients with liver cirrhosis presenting with right sided hydrothorax. The diagnosis of hepatic hydrothorax was confirmed by a radionuclide study using an intraperitoneal injection of radioactive 99mTc-tin-colloid, demonstrating the one-way transdiaphragmatic flow of fluid from the peritoneal to pleural cavities. Pleural taps, salt restriction and diuretics resulted in volume depletion and impaired renal function in the first patient. Medical therapy and a single thoracocentesis were successful in the other patient.

Aged↗

PubMed1995

Ovarian hyperstimulation syndrome manifests as acute unilateral hydrothorax.

Ovarian hyperstimulation syndrome may be a serious complication of ovulation induction usually manifested by ovarian enlargement and ascites. In its severe form, haemoconcentration, oliguria and hydrothorax may ensue. As evident from this case report, the usual sequence of events does not necessarily occur in all cases. Unilateral hydrothorax may be the only extra-ovarian manifestation of ovarian hyperstimulation syndrome.

Adult↗

PubMed1986

Demonstration of hydrothorax by intraperitoneal injection of technetium-99m MAA in the evaluation of peritoneovenous shunt patency.

A case of hydrothorax in a patient with recurrent ascites following Le Veen peritoneovenous shunt placement is presented. Patency of the Le Veen shunt was studied by the intraperitoneal injection of Tc-99m MAA with subsequent activity seen in the right hemithorax only. A standard perfusion lung scan showed only the left lung to be perfused. Thus, the right hemithorax activity seen could not be due to shunt patency, but represented direct communication between the labeled ascitic fluid and the right hydrothorax seen on chest x-ray.

Female↗

PubMed1989

External accumulation of radionuclide in hepatic hydrothorax.

Hepatic hydrothorax is a complication in approximately 5% of patients with cirrhosis. Ascites is almost always present and helps to suggest the correct diagnosis. However, when ascites is absent, radionuclide imaging has proven to be helpful in establishing that the pleural effusion originated from ascitic fluid. When pleural fluid is rapidly removed, such as by thoracostomy tube drainage, the radioisotope may accumulate outside the thorax and produce a negative scan of the chest. When the radionuclide scan is nondiagnostic and the pleural space is being rapidly drained, the pleural fluid collecting system should always be imaged before rejecting a diagnosis of hepatic hydrothorax.

Drainage↗

PubMed1996

Hepatic hydrothorax. Diagnosis and management.

Twelve cases of right hepatic hydrothorax are reported. Tc-99m SC that was injected intraperitoneally and intrapleurally provided evidence of a one-way flow of fluid from the peritoneal to the pleural cavity. Eight patients, whose hydrothorax was refractory to sodium restriction, diuretics and repeated thoracenteses, were treated by endopleural tetracycline instillation. The pathogenetic role of the diaphragmatic defect and the diagnostic usefulness of radionuclide imaging are stressed.

Adult↗

PubMed1996

Transjugular intrahepatic portosystemic shunt for the management of hepatic hydrothorax in the absence of ascites.

Hepatic hydrothorax in the absence of clinical ascites (HHAA) is a somewhat rare complication in decompensated cirrhosis. Patients with HHAA have a congenital defect in the tendinous portion of the diaphragm allowing rapid leakage of ascites into pleural cavity because of the cyclical negative intrathoracic pressure. Although several therapeutic approaches, including peritoneovenous shunt and chemical or surgical pleurodesis, have been attempted in these patients the results are largely unsatisfactory. A poor-risk surgical cirrhotic woman who was also considered not suitable for liver transplantation underwent transjugular intrahepatic portosystemic shunt (TIPS) for palliation of HHAA. After TIPS procedure hydrothorax completely resolved. TIPS can offer an attractive alternative to standard therapy in cirrhotic patients with HHAA.

Fatal Outcome↗

PubMed1980

Acute massive unilateral hydrothorax: a rare complication of chronic peritoneal dialysis.

We have described a case of massive unilateral hydrothorax during chronic peritoneal dialysis. The communication between the peritoneal and right pleural cavities was confirmed by injection into the peritoneal cavity of methylene blue, which promptly appeared in the pleural cavities. Peritoneal dialysis was continued, using decreased dialysate and a semisitting position. The possibility of continuing peritoneal dialysis in the patient with acute hydrothorax and in whom hemodialysis may be contraindicated is demonstrated.

Adult↗

PubMed1997

Tension hydrothorax.

Tension hydrothorax is a rare complication associated with a variety of diseases. In this case report, we describe the acute hemodynamic and respiratory effects of tube thoracostomy drainage in a patient with tension hydrothorax.

Aged↗

PubMed2001

Treatment of hepatic hydrothorax and reduction of chest tube output with octreotide.

Hepatic hydrothorax is a dreaded complication in patients with liver cirrhosis. Placement of chest tubes can alleviate respiratory distress, but patients often succumb due to excessive fluid and protein loss via the open drain. Our case illustrates that high-dose octreotide can strongly reduce hepatic hydrothorax drainage volume. This allows removal of the chest tube, which would otherwise not have been possible.

Chest Tubes↗

PubMed1992

A case of hepatic hydrothorax due to a large diaphragmatic defect.

Hepatic hydrothorax is an infrequent complication of cirrhosis. The source of pleural fluid has been the subject of considerable speculation. A case of hepatic hydrothorax is discussed which illustrates a large diaphragmatic defect as the cause of ascitic fluid passing into the pleural cavity.

Adult↗

PubMed1998

Hepatic hydrothorax in the absence of ascites.

Pleural effusion due to hepatic cirrhosis and ascites is well known, but hepatic hydrothorax in the absence of ascites is a rare complication. We report a case of liver cirrhosis due to hepatitis C virus with a large and recurring pleural effusion that had an apparent abdominal source in the absence of ascites. We review the characteristics and treatment for hepatic hydrothorax in the absence of ascites.

Adult↗

PubMed1973

Hydrothorax after central venous catheterization.

Three patients are described who developed hydrothorax as a complication of central venous catheterization. Respiratory distress associated with physical signs of fluid in the chest should arouse suspicion that the venous catheter has perforated the wall of the vein.The complications of central venous catheterization are reviewed and three cases of hydrothorax are presented. Comments on the prevention of these complications, their diagnosis and treatment if they occur, are made.

Adolescent↗

PubMed1991

Pulmonary sequestration: diagnosis with color Doppler sonography and a new theory of associated hydrothorax.

The diagnosis of pulmonary sequestration has traditionally relied on angiographic demonstration of a systemic artery to the sequestered lung tissue. Rarely, extralobar sequestration can be associated with tension hydrothorax, which in the past has invariably led to fetal hydrops and death. The authors report the cases of three infants who had initially undergone color and spectral Doppler analysis; in two of them, extralobar sequestrations were associated with congenital hydrothorax. All three patients underwent surgical resection and histopathologic evaluation of their sequestrations. On the basis of the findings, the authors believe that torsion of the sequestration occludes the efferent venous and lymphatic channels, initiating the accumulation of pleural fluid and subsequent hydrops through systemic venous obstruction. Color Doppler made possible the identification of minute feeding vessels, obviating further diagnostic studies.

Bronchopulmonary Sequestration↗

PubMed1989

Tension hydrothorax from intrapleural migration of a ventriculoperitoneal shunt.

A male newborn underwent a myelomeningocele repair, with subsequent placement of a ventriculoperitoneal shunt for treatment of hydrocephalus. Five days after shunt surgery, the infant acutely developed a deeply sunken fontanel, pallor, tachypnea, bradycardia, and irritability. Chest radiographs revealed intrathoracic migration of the distal shunt tubing and a tension hydrothorax. Treatment consisted of tube thoracostomy and temporary externalization of the distal shunt tubing. The patient fully recovered. The acute onset of shock in association with a sunken fontanel in a neonate with a shunt should raise the suspicion of tension hydrothorax. For critically ill infants immediate needle aspiration or thoracostomy is suggested. In less severely ill children, exposure of the shunt tubing in the neck and withdrawal of the pleural effusion by the distal shunt tubing may be performed as an emergency measure. The early recognition and urgent management of this problem are emphasized.

Cerebrospinal Fluid Shunts↗

PubMed1986

Fetal hydrothorax in the second trimester of pregnancy: successful intra-uterine treatment at 24 weeks gestation.

Two cases of fetal hydrothorax were diagnosed during ultrasound examination in asymptomatic women in the second trimester of pregnancy. One recognized at 19 weeks gestation increased in size. Thoracentesis at 24 weeks followed by continuous drainage for 7 days relieved the condition. The other diagnosed at 15 weeks resolved over the next month without interference. Each pregnancy resulted in a normal term infant. Aspiration of fetal hydrothorax should be performed when the condition appears progressive and is not associated with a major structural abnormality.

Drainage↗

PubMed1992

Uterine leiomyoma associated with ascites and hydrothorax.

Uterine leiomyoma associated with ascites and hydrothorax was apparently cured by total hysterectomy. This is believed to be the 15th recorded case of this type of Pseudo-Meigs' syndrome and the first in a patient with severe curvature of the spine and dorsolumbar scoliosis. The association with ascites and hydrothorax was investigated using 99mTc-labeled macroaggregated albumin.

Ascites↗