Hydrothorax is the synonym of
pleural effusion
A pleural effusion is accumulation of excessive fluid in the pleural space, the potential space that surrounds each lung.
Under normal conditions, pleural fluid is secreted by the parietal pleural capillaries at a rate of 0.6 millilitre per kilog ...
in which fluid accumulates in the
pleural cavity
The pleural cavity, or pleural space (or sometimes intrapleural space), is the potential space between the pleurae of the pleural sac that surrounds each lung. A small amount of serous pleural fluid is maintained in the pleural cavity to enabl ...
. This condition is most likely to develop secondary to
congestive heart failure
Heart failure (HF), also known as congestive heart failure (CHF), is a syndrome caused by an impairment in the heart's ability to fill with and pump blood.
Although symptoms vary based on which side of the heart is affected, HF typically pr ...
, following an increase in hydrostatic pressure within the lungs. More rarely, hydrothorax can develop in 10% of patients with
ascites
Ascites (; , meaning "bag" or "sac") is the abnormal build-up of fluid in the abdomen. Technically, it is more than 25 ml of fluid in the peritoneal cavity, although volumes greater than one liter may occur. Symptoms may include increased abdo ...
which is called
hepatic hydrothorax. It is often difficult to manage in end-stage liver failure and often fails to respond to therapy.
Pleural effusions may also develop following the accumulation of other fluids within the pleural cavity; if the fluid is blood it is known as
hemothorax (as in major chest injuries), if the fluid is pus it is known as
pyothorax (resulting from chest infections), and if the fluid is
lymph
Lymph () is the fluid that flows through the lymphatic system, a system composed of lymph vessels (channels) and intervening lymph nodes whose function, like the venous system, is to return fluid from the tissues to be recirculated. At the ori ...
it is known as
chylothorax
A chylothorax is an abnormal accumulation of chyle, a type of lipid-rich lymph, in the pleural space surrounding the lung. The lymphatic vessels of the digestive system normally return lipids absorbed from the small bowel via the thoracic duct, ...
(resulting from rupture of the
thoracic duct
In human anatomy, the thoracic duct (also known as the ''left lymphatic duct'', ''alimentary duct'', ''chyliferous duct'', and ''Van Hoorne's canal'') is the larger of the two lymph ducts of the lymphatic system (the other being the right lymph ...
).
Treatment
Treatment of hydrothorax is difficult for several reasons. The underlying condition needs to be corrected; however, often the source of the hydrothorax is end stage liver disease and correctable only by transplant. Chest tube placement should not occur. Other measures such as a
TIPS procedure are more effective as they treat the cause of the hydrothorax, but have complications such as worsened hepatic encephalopathy.
See also
*
Pleural effusion
A pleural effusion is accumulation of excessive fluid in the pleural space, the potential space that surrounds each lung.
Under normal conditions, pleural fluid is secreted by the parietal pleural capillaries at a rate of 0.6 millilitre per kilog ...
*
Pneumothorax
A pneumothorax is collection of air in the pleural space between the lung and the chest wall. Symptoms typically include sudden onset of sharp, one-sided chest pain and dyspnea, shortness of breath. In a minority of cases, a one-way valve is ...
References
*https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/hydrothorax
*Garbuzenko D.V., Arefyev N.O. Hepatic hydrothorax: An update and review of the literature. World J. Hepatol. 2017; 9 (31): 1197-1204
External links
{{Disorders of volume state
Diseases of pleura