Recurrent Massive Hydrothorax in a Patient with Decompensated Liver Cirrhosis
Aim: to demonstrate the need for a detailed differential diagnosis and selection of therapy in a patient with decompensated liver cirrhosis of combined etiology (HCV infection and primary sclerosing cholangitis). Key points. The patient came to the clinic with complaints of shortness of breath wit...
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| Format: | Article |
| Language: | Russian |
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Gastro LLC
2024-10-01
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| Series: | Российский журнал гастроэнтерологии, гепатологии, колопроктологии |
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| Online Access: | https://www.gastro-j.ru/jour/article/view/927 |
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| author | K. S. Zemlyanukhina I. N. Tikhonov M. S. Zharkova O. Yu. Kiseleva R. Т. Rzayev V. T. Ivashkin |
| author_facet | K. S. Zemlyanukhina I. N. Tikhonov M. S. Zharkova O. Yu. Kiseleva R. Т. Rzayev V. T. Ivashkin |
| author_sort | K. S. Zemlyanukhina |
| collection | DOAJ |
| description | Aim: to demonstrate the need for a detailed differential diagnosis and selection of therapy in a patient with decompensated liver cirrhosis of combined etiology (HCV infection and primary sclerosing cholangitis). Key points. The patient came to the clinic with complaints of shortness of breath with minimal physical activity, abdominal enlargement, swelling of the legs, yellowness of the skin, and severe weakness. The complaints arose two months after suffering from left-sided focal pneumonia. Laboratory tests revealed signs of systemic inflammation, liver failure, and acute kidney injury. According to the results of instrumental studies, massive hydrothorax was noted in the right pleural cavity. The patient underwent a series of thoracentesis, and a total of about four liters of non-inflammatory pleural fluid was evacuated. Differential diagnosis was based on the presence of dyspnea and respiratory failure. The patient received effective antiviral therapy with drugs using an interferon-free regimen. Subsequently, conservative therapy was carried out, against the background of which the symptoms regressed and the patient’s condition improved. Conclusions. Hepatopleural syndrome is a serious complication in patients with decompensated liver cirrhosis, although it does not always appear secondary to massive ascites. To resolve hepatic hydrothorax, it is necessary to carry out diuretic therapy, replacement transfusion therapy with albumin preparations, and if there is a large amount of fluid in the pleural cavities, therapeutic and diagnostic thoracentesis is recommended. |
| format | Article |
| id | doaj-art-f91f5e1019124af1b8c8b62b5ef2db49 |
| institution | Kabale University |
| issn | 1382-4376 2658-6673 |
| language | Russian |
| publishDate | 2024-10-01 |
| publisher | Gastro LLC |
| record_format | Article |
| series | Российский журнал гастроэнтерологии, гепатологии, колопроктологии |
| spelling | doaj-art-f91f5e1019124af1b8c8b62b5ef2db492025-02-10T16:14:39ZrusGastro LLCРоссийский журнал гастроэнтерологии, гепатологии, колопроктологии1382-43762658-66732024-10-0134410411210.22416/1382-4376-2024-34-4-104-112928Recurrent Massive Hydrothorax in a Patient with Decompensated Liver CirrhosisK. S. Zemlyanukhina0I. N. Tikhonov1M. S. Zharkova2O. Yu. Kiseleva3R. Т. Rzayev4V. T. Ivashkin5I.M. Sechenov First Moscow State Medical University (Sechenov University)I.M. Sechenov First Moscow State Medical University (Sechenov University)I.M. Sechenov First Moscow State Medical University (Sechenov University)I.M. Sechenov First Moscow State Medical University (Sechenov University)I.M. Sechenov First Moscow State Medical University (Sechenov University)I.M. Sechenov First Moscow State Medical University (Sechenov University)Aim: to demonstrate the need for a detailed differential diagnosis and selection of therapy in a patient with decompensated liver cirrhosis of combined etiology (HCV infection and primary sclerosing cholangitis). Key points. The patient came to the clinic with complaints of shortness of breath with minimal physical activity, abdominal enlargement, swelling of the legs, yellowness of the skin, and severe weakness. The complaints arose two months after suffering from left-sided focal pneumonia. Laboratory tests revealed signs of systemic inflammation, liver failure, and acute kidney injury. According to the results of instrumental studies, massive hydrothorax was noted in the right pleural cavity. The patient underwent a series of thoracentesis, and a total of about four liters of non-inflammatory pleural fluid was evacuated. Differential diagnosis was based on the presence of dyspnea and respiratory failure. The patient received effective antiviral therapy with drugs using an interferon-free regimen. Subsequently, conservative therapy was carried out, against the background of which the symptoms regressed and the patient’s condition improved. Conclusions. Hepatopleural syndrome is a serious complication in patients with decompensated liver cirrhosis, although it does not always appear secondary to massive ascites. To resolve hepatic hydrothorax, it is necessary to carry out diuretic therapy, replacement transfusion therapy with albumin preparations, and if there is a large amount of fluid in the pleural cavities, therapeutic and diagnostic thoracentesis is recommended.https://www.gastro-j.ru/jour/article/view/927liver cirrhosisportal hypertensionpneumoniahydrothoraxhepatopleural syndrome |
| spellingShingle | K. S. Zemlyanukhina I. N. Tikhonov M. S. Zharkova O. Yu. Kiseleva R. Т. Rzayev V. T. Ivashkin Recurrent Massive Hydrothorax in a Patient with Decompensated Liver Cirrhosis Российский журнал гастроэнтерологии, гепатологии, колопроктологии liver cirrhosis portal hypertension pneumonia hydrothorax hepatopleural syndrome |
| title | Recurrent Massive Hydrothorax in a Patient with Decompensated Liver Cirrhosis |
| title_full | Recurrent Massive Hydrothorax in a Patient with Decompensated Liver Cirrhosis |
| title_fullStr | Recurrent Massive Hydrothorax in a Patient with Decompensated Liver Cirrhosis |
| title_full_unstemmed | Recurrent Massive Hydrothorax in a Patient with Decompensated Liver Cirrhosis |
| title_short | Recurrent Massive Hydrothorax in a Patient with Decompensated Liver Cirrhosis |
| title_sort | recurrent massive hydrothorax in a patient with decompensated liver cirrhosis |
| topic | liver cirrhosis portal hypertension pneumonia hydrothorax hepatopleural syndrome |
| url | https://www.gastro-j.ru/jour/article/view/927 |
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