Recurrent hydrothorax and surgical diaphragmatic repair report of 2 cases and review of the literature

A. Christine Argento*, Anthony Kim, Melissa Knauert-Brown, Daniel Boffa, Mark D. Siegel, Behrouz Jafari, Jonathan T. Puchalski

*Corresponding author for this work

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Background: Pleural effusions may result from intraabdominal processes and sometimes present with dramatic clinical consequences. We present 2 cases of recurrent hydrothorax requiring surgical repair of diaphragmatic defects and describe when surgery may be the best treatment modality. Patient 1: A 63-year-old man with end-stage renal disease requiring peritoneal dialysis presented with dyspnea on exertion that progressed to cardiac arrest. He was found to have a tension hydrothorax that was initially stabilized with thoracentesis and tube thoracostomy. He eventually underwent surgical repair of fenestrations with complete resolution of his effusion. Patient 2: A 52-year-old man with recurrent hydrothorax in the context of hepatitis C cirrhosis and hepatocellular carcinoma following radiofrequency ablation to his liver had recurrent admissions with dyspnea and a large pleural effusion. When medical therapy failed, he underwent surgical repair of a large diaphragmatic defect. Conclusions: Hydrothorax related to peritoneal dialysis or cirrhosis may cause life-threatening scenarios in which medical management may stabilize the patient. Ultimately, surgical corrections of diaphragmatic defects may be necessary for definitive management in selected patients. Although these scenarios are rare, clinicians should be aware of these possibilities as early collaboration between medical and surgical services is essential for optimal patient care.

Original languageEnglish (US)
Pages (from-to)150-153
Number of pages4
JournalJournal of Bronchology and Interventional Pulmonology
Volume21
Issue number2
DOIs
StatePublished - Apr 2014

Keywords

  • Continuous ambulatory peritoneal dialysis (CAPD)
  • Hepatic hydrothorax
  • Pleuroperitoneal leak

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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