Cirrhosis pleural effusion

It is not clearly understood why in some cases oedema without ascites and in other cases ascites without oedema as well as ascites together with oedema or even pleural effusion without ascites occur. Ascites develops most frequently during the course of liver disease (= hepatogenic ascites), in particular in chronic liver diseases with portal hypertension (= portal ascites), (s. tab. 16.7) Various mechanical, biochemical and neural disorders overlap in their effects and pathways, depending on the underlying liver disease. Only rarely is ascites found in diseases with presinusoidal localization of portal hypertension (such as portal vein thrombosis) or with minor restrictions in the synthesis of albumin (as in biliary cirrhosis). Formation of ascites occurs in about 50% of all cirrhotic patients within 10 years of... 

Ascites and oedema are also found in severe hepatic diseases, pointing to serious disorders in the water and electrolyte metabolism. These complications are signs of decompensation in fiver cirrhosis or chronic liver insufficiency. At the same time, pleural effusion may also be evident. Cirrhosis-related pleural effusion without concomitant ascites has been described as a rarity. (see chapter 16)... 

Pleural effusions Liver cirrhosis Chronic hepatitis Acute viral hepatitis After liver transplantation Echinococcosis Liver abscess After sclerotherapy of oesophageal varices... 

Haitjema, T., de Maat, C.EJVI. Pleural effusion without ascites in a patient with cirrhosis. Neth. X Med. 1994 44 207 - 209... 

Llaneza, RR, Salt, W.S. Unilateral pleural effusion without clinical ascites in Laennec s cirrhosis. Dig. Dis. Sci. 1985 30 88-91... 

Hepatic hydrothorax (C.S. Morrow et al., 1958) is evident during the course of liver cirrhosis with ascites in 0.4-12% of cases. The mean frequency is about 6%, although in two-thirds of the cases, a right-sided effusion (with the author s own patients a bilateral effusion) was ascertained. (66) (s. fig. 16.8) Hepatic hydrothorax is a transudate cell count protein concentration <2.5 g/dl, total protein effusion to serum ratio <0.5, LDH effusion to serum ratio <2.3, serum to pleural fluid albumin gradient >1.1 g/dl. (s. also fig. 16.9) (17, 37, 47, 52 - 54, 66)... 

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