Anesth Analg 2004;99:1803-1804
© 2004 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000138034.73465.D3
CRITICAL CARE AND TRAUMA
Hepatic Hydrothorax in the Absence of Ascites: Respiratory Failure in a Cirrhotic Patient
Jordi Serrat, MD,
Julio J. Roza, MD, and
Teresa Planella, MD
Servei d’Anestesiologia i Reanimació, Hospital General de Vic, Barcelona, Spain
Address correspondence and reprint requests to Jordi Serrat, MD, Servei d’Anestesiologia i Reanimació, Hospital General de Vic, C/ Francesc Pla s/n, 08500 Vic, Barcelona, Spain. Address e-mail to jserrat{at}hgv.es
The frequency of hepatic hydrothorax in cirrhotic patients is reported to be approximately 5%. The pleural effusion is predominantly right-sided (85% of cases) but may be bilateral. Although most often accompanied by significant ascites, it can occur in its absence. We report a case of a right-sided acute hepatic hydrothorax as a result of residual motor blockade during anesthesia recovery and without previous evidence of clinical ascites. This complication should be considered by the anesthesiologist in every cirrhotic patient, with or without clinical evidence of ascites.
IMPLICATIONS: Hydrothorax is a pleural space fluid accumulation. Most pleural effusions are rarely observed. Although unusual, these effusions associated with hepatic cirrhosis and ascites have been well described. However, the case we present here showed no clinical signs of ascites before surgery. Therefore, the patient developed a right-sided hydrothorax as a result of residual motor blockade during anesthesia recovery.
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