Metrics details. The Hepatic hydrothorax is a pleural effusion related to portal hypertension; its diagnosis and therapeutic management may be difficult. The aims of this article are which follows: To gather the practices of hepatogastroenterologists or pulmonologists practitioners regarding the diagnosis and management of the hepatic hydrothorax. Practitioners from 13 French- speaking countries were invited to answer an online questionnaire on the hepatic hydrothorax diagnosis and its management.
The results of this large study provide important data on practices of French speaking hepatogastroenterologists and pulmonologists; it appears that recommendations are warranted. Peer Review reports. The Hepatic hydrothorax HH is defined by the presence of a pleural effusion of a transudative nature greater than ml secondary to some portal hypertension in a cirrhotic patient, in the absence of any causes of cardiopulmonary or malignant origins [ 1 ].
The poor tolerance of the HH makes its therapeutic management difficult, which can be a source of iatrogenic complications [ 1 , 2 , 3 , 4 ]. The treatment of HH is mainly determined by whether or not a liver transplantation is feasable [ 2 , 5 , 6 ]. The mechanism of the HH formation is related to a unidirectional transfer of abdominal ascites to the pleural cavity through diaphragmatic breaches [ 4 ].
These breaches range in size from 0. We can observe a unidirectional passage of ascites formed on the surface of the liver from the peritoneal cavity to the pleura under a hydrostatic pressure gradient, and the HH will surface when the accumulation of ascites in the pleural space exceeds the resorptive capacities of the pleura [ 7 ]. This mecanism leads to different treatments possibilities.
Although there exists an extensive literature [ 1 ] on the hepatic hydrothorax and a recent very complete published review [ 8 ], there are no established and internationally recognized recommendations on the modalities of diagnosis and therapeutic management. This international francophone survey was conducted prospectively among French-speaking HG or PN practitioners in university hospitals UH , general hospitals GH , and private clinics in several francophone countries.
