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Hepatic Hydrothorax

Contact the UPMC Center for Liver Diseases

To make an appointment with a hepatologist at the UPMC Center for Liver Diseases, call 412-647-1170 or fill out our contact form.


What Is Hepatic Hydrothorax?

Hepatic hydrothorax is a complication of cirrhosis of the liver.

It happens when fluid moves from the abdomen into the space around the lungs, causing shortness of breath and other problems.

About 4.5 million people in the U.S. suffer from liver disease. Almost 43,000 die each year from chronic liver disease and cirrhosis.

About 5% to 10% of people with cirrhosis end up getting hepatic hydrothorax.

Hepatic hydrothorax causes

Having advanced liver disease causes hepatic hydrothorax. It happens when the liver can't filter the blood properly, and fluid backs up into the space around the lungs.

Hepatic hydrothorax risk factors and complications

You're at an increased risk for hepatic hydrothorax if you have cirrhosis or other advanced liver diseases, such as:

  • Ascites (fluid in the belly).
  • Esophageal varices ( swollen veins in the esophagus).
  • Portal hypertension (high blood pressure around the liver).
  • Small, otherwise harmless holes in the diaphragm, present from birth that allow fluid to enter the lung s.

Hepatic hydrothorax is often a sign that your liver condition is getting worse.

A complication of hepatic hydrothorax is getting a lung infection.

How to prevent hepatic hydrothorax

The only sure way to prevent this condition is to keep your liver healthy. People who drink too much alcohol or have hepatitis are at risk for liver disease.

If you have liver disease, you can stop further damage by:

  • Eating a healthy diet.
  • Staying at a healthy weight.
  • Not drinking alcohol.
  • Seeing your liver doctor on a routine basis.

Why Choose the UPMC Center for Liver Diseases?

Our doctors are experts at treating cirrhosis of the liver. They also know how to treat its complications, such as hepatic hydrothorax.

UPMC has the latest in cutting-edge technologies and research in liver disease.

And, we're home to one of the oldest and most experienced liver transplant centers in the U.S.

Hepatic Hydrothorax Symptoms and Diagnosis

Hepatic hydrothorax mainly happens on the right side of the body, where the liver is. The right lung becomes compressed when fluid builds up around it.

Signs of hepatic hydrothorax include:

  • Shortness of breath.
  • Fluid on the right side of the chest.
  • A dry cough that doesn't produce mucus.
  • Low levels of oxygen in the blood.
  • Chest pain.
  • Fatigue.

Diagnosing hepatic hydrothorax

Your doctor will do a physical exam and ask you about your health history.

Fluid in the lung cavity can occur with other conditions, such as heart disease. If someone has liver disease but not heart disease, the fluid in the lung cavity is more likely hepatic hydrothorax.

Your doctor may order the following tests to confirm a diagnosis:

  • CT scan of the chest.
  • Ultrasound of the liver.
  • Thoracentesis to test fluid in the lung cavity.

Hepatic Hydrothorax Treatment

The experts at UPMC treat challenging complications of liver disease, including hepatic hydrothorax.

Your doctor may use a mix of treatments such as lifestyle changes, drugs, and surgery.

Changes in diet

Your doctor will likely ask you to limit your salt (sodium) intake.

Salt causes you to retain water, which can add to fluid build-up in the lungs.

Medicine to treat hepatic hydrothorax

Your doctor may prescribe water pills to help rid your body of salt and water.

That can help lower high blood pressure in the liver.

Surgery for hepatic hydrothorax

Your doctor may decide the best approach to treat your hepatic hydrothorax is surgery, such as:

  • Thoracentesis to remove fluid from the space around the lungs. It can provide relief from shortness of breath.
  • Paracentesis to remove fluid from the abdominal cavity. Doctors use it to treat ascites. It can also ease pressure on the lungs and provide relief for those with hepatic hydrothorax.
  • Transjugular intrahepatic portosystemic shunt (TIPS) to reduce portal hypertension by bypassing the damaged liver. Doctors connect the portal and hepatic veins, then insert a stent to increase blood flow. This helps ease pressure on the veins and relieve fluid build-up in the abdominal and lung cavities.
  • Liver transplant. If other treatments don't work and you're healthy enough, you may need a liver transplant. During transplant, surgeons remove your damaged liver and replace it with a healthy one from an organ donor.