Pneumothorax Ex-vacuo or “trapped lung” in the setting of hepatic hydrothorax

BMC Pulmonary Medicine

Tisha S Wang²  Ronald Busuttil¹  M Iain Smith²  Patricia Eshaghian²  Ali Zarrinpar¹  Catherine A Lazar²  Irawan Susanto²  Yan S Kim² 

[1] Dumont-UCLA Liver Cancer and Transplant Centers, Pfleger Liver Institute, Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, California, USA;Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine at University of California, 10833 Le Conte Ave, Room 37-131 CHS, Los Angeles, CA, 90095, USA

关键词: Pleural effusion;    Pnumothorax Ex-Vacuo;    Trapped lung;    Hepatohydrothorax;   

Others  :  1136273
DOI  :  10.1186/1471-2466-12-78

 received in 2012-05-09, accepted in 2012-11-29,  发布年份 2012

【 摘 要 】

Background

Hepatic hydrothorax is a major pulmonary complication of liver disease occurring in up to 5-10% of patients with cirrhosis.

Case presentation

We report four observations of the development of pneumothorax ex-vacuo or trapped lung in the setting of hepatic hydrothorax. The diagnosis of trapped lung was made based on the presence of a hydropneumothorax after evacuation of a longstanding hepatic hydrothorax with failure of the lung to re-expand after chest tube placement in three of the four cases. Two patients underwent surgical decortication with one subsequent death from post-operative bleeding. The other two patients remarkably had spontaneous improvement of their “trapped lung” without surgical intervention.

Conclusions

While pneumothorax ex-vacuo is a known phenomenon in malignant effusions, to our knowledge, it has never been described in association with hepatic hydrothoraces. The pathophysiology of this phenomenon remains unclear but could be related to chronic inflammation with development of a fibrous layer along the visceral pleura.

【 授权许可】

   
2012 Kim et al.; licensee BioMed Central Ltd.

【 图 表 】

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