Hepatic hydrothorax with and without ascites: scintigraphic demonstration of functional unidirectional diaphragmatic leaks

Asitli asitsiz hepatik hidrotoraks. Tek yönlü diyafragmatik kaçağın sintigrafiyle gösterilmesi

Özet

Karaciğer sirozlu hastalarda özellikle asit gelişmemişse hidrotoraks ender gelişir. Hidrotoraksın karaciğer orijinli olduğunu kabul etmezden önce akciğer, kalb ve böbrek pa¬tolojileri elimine edilmelidir. Asitsiz hastalarda tanı güçleşir. 2 karaciğer sirozlu (biri asitsiz) ve sağ hidrotorakslı hastada radyoizotop tekniğiyle plevral sıvının karın orijinli olduğunu gös¬terdik. Karşı yönde sıvı transferi yoktu.

Abstract

Hydrothorax is not a very common symptom in patients with hepatic cirrhosis, especially when there is no clinical evidence of concomitant ascites. Before accepting the hepatic origin of the hydrothorax it is necessary to exclude other cardiac, pulmonary or renal pathologies which could be partly or entirely responsible for this symptom. The existence of ascites may help to suggest the origin of hydrothorax. in patients with hydrothorax vvithout ascites, es-tablishing the diagnose is more complicated. We present two hepatic cirrhotic patients with right hydothorax in the absence and presence of ascites using radioisotopic techniques it was demonstrated that in both situations the pleural fluid originated in the abdomen and hence was transported into the pleural cavity. There was no fluid transfer in the opposite direction.