Pathogenesis and Treatment of Hydrothorax Complicating Cirrhosis with Ascites
Authors: FRED L. LIEBERMAN
Journal: Annals of Internal Medicine (1966)

Article1 February 1966Pathogenesis and Treatment of Hydrothorax Complicating Cirrhosis with AscitesFRED L. LIEBERMAN, M.D., RYUGO HIDEMURA, M.D., ROBERT L. PETERS, M.D., TELFER B. REYNOLDS, M.D., F.A.C.P.FRED L. LIEBERMAN, M.D., RYUGO HIDEMURA, M.D., ROBERT L. PETERS, M.D., TELFER B. REYNOLDS, M.D., F.A.C.P.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-64-2-341 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptHydrothorax has long been recognized as a complication of cirrhosis, but there has been much speculation as to its origin. Higgins and his colleagues (1) suggested it forms from the plasma as a result of hypoalbuminemia and a decreased colloid osmotic pressure. Morrow, Kanter, and Armen (2) considered leakage of plasma from a hypertensive azygous venous system as being a possible cause. Eisenmenger (3) has suggested it may be lymph leaking from a thoracic duct system overburdened by ascites reabsorption. All investigators agree, however, that it is associated with the presence of ascites, and isolated case studies have provided evidence...References1. HIGGINSKELSALLO'BRIENSTEWARTWITTS GARJRAMLJ: Ascites in chronic disease of the liver. Quart. J. Med. 16: 263, 1947. MedlineGoogle Scholar2. MORROWKANTERARMEN CSMRN: Hepatic hydrothorax. Ann. Intern. Med. 49: 193, 1958. LinkGoogle Scholar3. EISENMENGER WJ: Part VII, Edema associated with liver disease, in Edema Mechanisms and Management; a Hahnemann symposium on salt and water retention, edited by MOYER, J. H., FUCHS, M. W. B. Saunders Co., Philadelphia, 1960, pp. 626-627. Google Scholar4. EMERSONDAVIES PAJH: Hydrothorax complicating ascites. Lancet 268: 487, 1955. CrossrefMedlineGoogle Scholar5. JOHNSTONLOO RFRV: Hepatic hydrothorax: studies to determine the source of the fluid and report of thirteen cases. Ann. Intern. Med. 61: 385, 1964. LinkGoogle Scholar6. MEIGSARMSTRONGHAMILTON JVSHHH: A further contribution to the syndrome of fibroma of the ovary with fluid in the abdomen and chest, Meigs' syndrome. Amer. J. Obstet. Gynec. 46: 19, 1943. CrossrefGoogle Scholar7. MCKAYSPARLINGROBBINS DGHSSL: Cirrhosis of the liver with massive hydrothorax. Arch. Intern. Med. (Chicago) 79: 501, 1947. CrossrefGoogle Scholar8. COURTICESTEINBECK FCAW: The lymphatic drainage of plasma from the peritoneal cavity of the cat. Aust. J. Exp. Biol. Med. Sci. 28: 161, 1950. CrossrefMedlineGoogle Scholar9. ABDOUREINHARDTTARVER IAWOH: Plasma protein III. The equilibrium between blood and lymph protein. J. Biol. Chem. 194: 15, 1952. CrossrefMedlineGoogle Scholar10. DUMONTMULHOLLAND AEJH: Flow rate and composition of thoracic duct-lymph in patients with cirrhosis. New Eng. J. Med. 263: 471, 1960. CrossrefMedlineGoogle Scholar11. CROFTS NF: Pneumothorax complicating therapeutic pneumoperitoneum. Thorax 9: 226, 1954. CrossrefMedlineGoogle Scholar12. ROSSFARBER JJE: Right sided spontaneous pneumothorax complicating therapeutic pneumoperitoneum. Amer. Rev. Tuberc. 63: 67, 1951. Google Scholar13. YANNITELLIWOODRUFFMUELLERHOWARD SACEEEWL: Fatal tension pneumothorax resulting from diaphragmatic rupture in a patient receiving pneumoperitoneum. Amer. Rev. Tuberc. 60: 794, 1949. Google Scholar14. LAIRD R: Comments on total thoracoscopy. Tubercle 26: 149, 1945. CrossrefMedlineGoogle Scholar15. CHRISTIAN HA: Bloody pleural fluid, an unusual complication of cirrhosis of the liver. Ann. Intern. Med. 10: 1621, 1937. LinkGoogle Scholar16. FROTHINGHAM JR: Cirrhosis of the liver complicated by persistent right hydrothorax and ascites. New Eng. J Med. 226: 679, 1942. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Los Angeles, CaliforniaFrom the Hepatic Service of the John Wesley County Hospital and the University of Southern California School of Medicine, Los Angeles, Calif.This study was supported in part by research grant HE 09316 from the National Institutes of Health, Bethesda, Md.Requests for reprints should be addressed to Telfer B. Reynolds, M.D., Department of Medicine, University of Southern California School of Medicine, 2025 Zonal Ave., Los Angeles, Calif. 90033. 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