TY - JOUR
T1 - Recurrent hydrothorax and surgical diaphragmatic repair report of 2 cases and review of the literature
AU - Argento, A. Christine
AU - Kim, Anthony
AU - Knauert-Brown, Melissa
AU - Boffa, Daniel
AU - Siegel, Mark D.
AU - Jafari, Behrouz
AU - Puchalski, Jonathan T.
N1 - Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 2014/4
Y1 - 2014/4
N2 - 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.
AB - 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.
KW - Continuous ambulatory peritoneal dialysis (CAPD)
KW - Hepatic hydrothorax
KW - Pleuroperitoneal leak
UR - http://www.scopus.com/inward/record.url?scp=84905817252&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84905817252&partnerID=8YFLogxK
U2 - 10.1097/LBR.0000000000000047
DO - 10.1097/LBR.0000000000000047
M3 - Article
C2 - 24739690
AN - SCOPUS:84905817252
VL - 21
SP - 150
EP - 153
JO - Journal of Bronchology and Interventional Pulmonology
JF - Journal of Bronchology and Interventional Pulmonology
SN - 1944-6586
IS - 2
ER -