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Hepatic hydrothorax : a comprehensive approach to diagnosis and management

datacite.subject.fosCiências Médicas
datacite.subject.sdg03:Saúde de Qualidade
dc.contributor.authorMendos, Ivo
dc.contributor.authorInácio, Ana Siopa
dc.contributor.authorUrbano, Martim Costa
dc.contributor.authorCalvinho, Paulo
dc.contributor.authorNunes, Gonçalo
dc.date.accessioned2026-06-09T13:43:42Z
dc.date.available2026-06-09T13:43:42Z
dc.date.issued2026-01
dc.description.abstractBackground: Hepatic hydrothorax (HH) is an uncommon but serious complication of advanced cirrhosis, characterized by transudative pleural effusion in the absence of cardiopulmonary or renal pathology. Despite its relatively low prevalence, HH carries significant morbidity and mortality, often presenting complex diagnostic and therapeutic challenges. Summary: The pathogenesis of HH is multifactorial, primarily involving the passage of ascitic fluid through diaphragmatic defects, exacerbated by altered hemodynamics, hypoalbuminemia, and neurohormonal dysregulation. Diagnosis relies on identifying transudative pleural effusion and excluding alternative etiologies. Management requires a stepwise multidisciplinary approach. Initial therapy includes sodium restriction, diuretics, and paracentesis to control ascites. Refractory cases may require serial thoracenteses, transjugular intrahepatic portosystemic shunt (TIPS), or surgical interventions in selected cases. Liver transplantation remains the definitive treatment leading to survival outcomes comparable to other transplant indications. Conclusion: HH develops in advanced cirrhosis and predicts a poor prognosis, with median survival often less than 1 year without transplantation. Optimal care requires early recognition, individualized treatment planning, and close multidisciplinary coordination between hepatology, pulmonology, interventional radiology, and surgical teams. Further research is needed to refine risk stratification and establish standardized management algorithms to improve patient outcomes.eng
dc.identifier.citationIvo Mendes, Ana Siopa Inácio, Martim Costa Urbano, Paulo Calvinho, Gonçalo Nunes; Hepatic Hydrothorax: A Comprehensive Approach to Diagnosis and Management. GE Port J Gastroenterol 1 January 2026; 33 (1): 396–407. https://doi.org/10.1159/000550982
dc.identifier.doi10.1159/000550982
dc.identifier.issn2387-1954
dc.identifier.urihttp://hdl.handle.net/10400.26/63562
dc.language.isoeng
dc.peerreviewedyes
dc.publisherKarger
dc.relation.hasversionhttps://doi.org/10.1159/000550982
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.subjectHepatic hydrothorax
dc.subjectChronic liver disease
dc.subjectCirrhosis
dc.subjectPortal hypertension
dc.titleHepatic hydrothorax : a comprehensive approach to diagnosis and managementeng
dc.typecontribution to journal
dspace.entity.typePublication
oaire.citation.endPage407
oaire.citation.issue1
oaire.citation.startPage396
oaire.citation.titleGE – Portuguese Journal of Gastroenterology
oaire.citation.volume33
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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