Pleuroperitoneal shunt in a patient with hepatic hydrothorax

Abstract

Hepatic hydrothorax is a term that describes a pleural effusion induced by cirrhosis; these effusions are often resistant to standard medical therapy. The usefulness of pleuroperitoneal shunts for intractable pleural effusions has been reported, but there are few reports describing the use of this shunt for hepatic hydrothorax. We report our successful experience with a pleuroperitoneal shunt for palliative treatment of hepatic hydrothorax in a patient with cirrhosis. Our patient had class B liver cirrhosis per the Child-Pugh classification system. Two months prior to the procedure, she had undergone percutaneous coronary intervention for unstable angina. We selected a pleuroperitoneal shunt for noninvasive, palliative treatment of an intractable pleural effusion in this high-risk patient. After surgery, the pleural effusion was well controlled and our patient was able to live her daily life at home for 6 months before she died of complications related to shunt occlusion. The pleuroperitoneal shunt should be considered a useful treatment option for hepatic hydrothorax, especially in high-risk patients.