Role of the peritoneopleural pressure gradient in the genesis of hepatic hydrothorax. An isotopic study

Ajmi, S.; Sfar, R.; Nouira, M.; Souguir, A.; Jmaa, A.; Golli, L.; Fredj, M. Ben; Essabbah, H.

doi:10.1016/j.gcb.2008.04.032

Cited by 12 publications

(15 citation statements)

References 22 publications

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“…In our patient, radionuclide imaging showed the unidirectional flow of contrast material from peritoneal cavity to the pleural cavity as previously described. We believe that she continued to have significant pleural effusion despite pleurodesis secondary to rapid re‐accumulation of the fluid arising from the abdominal cavity, although she did not have ascites, which did not allow the visceral and parietal pleural surfaces to adhere as previously described in other case‐reports 11–15. This particular patient had an unusually high CSF production rate confirmed during prior shunt externalization of approximately 800 ml/day.…”

Section: Discussionmentioning

confidence: 55%

“…Other case studies have demonstrated the unidirectional flow of the fluid from the abdomen to the pleural cavity 9, 11–13. This one‐way flow is probably due to pressure gradient results from a cyclic negative intrathoracic pressure during the inspiration and a positive intra‐abdominal pressure 11–13. Reports have revealed the resolution of pleural effusion by using positive pressure ventilation 13, 14…”

Section: Discussionmentioning

confidence: 97%

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Recurrent pleural effusion without intrathoracic migration of ventriculoperitoneal shunt catheter: A case report

Chuen-im

Smyth

Segura

et al. 2011

Pediatric Pulmonology

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Pleural effusion is a rare complication of ventriculoperitoneal (VP) shunting, usually due to the migration of the VP shunt catheter into the thorax. Herein we report a neurologically disadvantaged child with a lobar holoprosencephaly and hydrocephalus, initially treated with a VP shunt, who years later developed recurrent right-sided pleural effusion ultimately confirmed to be a cerebrospinal fluid (CSF) hydrothorax without intra-thoracic migration of the distal shunt catheter. Thoracentesis was compatible with a transudative effusion. Given the presence of a persistent pleural effusion, beta-2 transferrin concentrations were measured, which yielded a positive result. Plain radiographs and head computed tomography (CT) showed a normally positioned, functional VP shunt. A spine CT myelogram to look for a spinal dural-thoracic CSF fistula was negative. A radionuclide CSF shunt study demonstrated normal functioning VP shunt with radiotracer accumulation within the peritoneum, with subsequent tracer rapidly accumulating in the right hemithorax. Video-assisted thoracoscopic (VATS) exploration with drainage of the pleural effusion and pleurodesis was then performed. No diaphragmatic defect or shunt tubing within the thorax was found and the procedure failed to resolve the effusion. The patient's recurrent effusion was ultimately resolved with intracranial endoscopic choroid plexus coagulation to decrease CSF output.

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 97%

Recurrent pleural effusion without intrathoracic migration of ventriculoperitoneal shunt catheter: A case report

Chuen-im

Smyth

Segura

et al. 2011

Pediatric Pulmonology

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“…( 20 ) Although not offered in all centers, scintigraphy can aid in the diagnosis as lack of migration of radioisotope into the pleural cavity suggests an alternate cause of pleural effusion. ( 10,17,31 ) HH can also be diagnosed through direct visualization of diaphragmatic defects by video‐assisted thoracoscopic surgery (VATS), although this procedure is invasive and should be performed only if the diagnosis remains unclear or there is a plan to repair the defect. ( 5,10 )…”

Section: Diagnosismentioning

confidence: 99%

Multidisciplinary Management of Hepatic Hydrothorax in 2020: An Evidence‐Based Review and Guidance

et al. 2020

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“…Velocity of ascitic fluid movement into the pleural cavity is reportedly proportional to the pressure difference between the pleural and peritoneal cavities 16 . We therefore supposed the following from the results of this study.…”

Section: Discussionmentioning

confidence: 61%

“…Velocity of ascitic fluid movement into the pleural cavity is reportedly proportional to the pressure difference between the pleural and peritoneal cavities. 16 We therefore supposed the following from the results of this study. In three of the five patients diagnosed with hepatic hydrothorax and showing turbinated enhancement, a large pressure difference between the pleural and peritoneal cavities caused a large volume of Sonazoid to move into the pleural cavity.…”

Section: Discussionmentioning

confidence: 98%

Diagnosis of hepatic hydrothorax using contrast‐enhanced ultrasonography with intraperitoneal injection of Sonazoid

Tamano

Hashimoto

Kojima

et al. 2010

J of Gastro and Hepatol

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Background and Aim: We investigated the utility and safety of contrast-enhanced ultrasonography using Sonazoid in the diagnosis of hepatic hydrothorax. Methods: The study consisted of seven liver cirrhosis patients with hydrothorax and hydroperitoneum. After obtaining informed consent, Sonazoid was injected intraperitoneally, and enhancement in the peritoneal and pleural cavities was observed. Results: In all patients, the peritoneal cavity was quickly enhanced after the Sonazoid injection. The pleural cavity was enhanced in five of the seven patients, and these five patients were diagnosed with hepatic hydrothorax. Two patients without enhancement of the pleural cavity were diagnosed with inflammatory hydrothorax. Conclusions: This is the first report to confirm transdiaphragmatic movement of ascitic fluid into the pleural cavity using contrast-enhanced ultrasonography with Sonazoid. This method can safely detect ascitic flow in real time, and is thus very useful for the diagnosis of hepatic hydrothorax.

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Role of the peritoneopleural pressure gradient in the genesis of hepatic hydrothorax. An isotopic study

Cited by 12 publications

References 22 publications

Recurrent pleural effusion without intrathoracic migration of ventriculoperitoneal shunt catheter: A case report

Recurrent pleural effusion without intrathoracic migration of ventriculoperitoneal shunt catheter: A case report

Multidisciplinary Management of Hepatic Hydrothorax in 2020: An Evidence‐Based Review and Guidance

Diagnosis of hepatic hydrothorax using contrast‐enhanced ultrasonography with intraperitoneal injection of Sonazoid

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