山东大学：《诊断学》课程教学资源（PPT课件讲稿）Hepatic Hydrothorax

Hepatic Hydrothorax

Hepatic Hydrothorax

63 year-old female with biopsy- proven cirrhosis secondary to alpha-1-antitrypsin deficiency complained of shortness of breath and cough productive of scant amounts of mucoid phlegm for 1 week

• 63 year-old female with biopsy￾proven cirrhosis secondary to alpha-1-antitrypsin deficiency complained of shortness of breath and cough productive of scant amounts of mucoid phlegm for 1 week

She denied fevers or chills.In the post,she had undergone a total abdominal hysterectomy and radiation therapy for uterine cancer as well as a sigmoid resection for radiation colitis

• She denied fevers or chills. In the post, she had undergone a total abdominal hysterectomy and radiation therapy for uterine cancer as well as a sigmoid resection for radiation colitis

Follow up evaluations had not shown signs of cancer recurrence

• Follow up evaluations had not shown signs of cancer recurrence

She did not smoke or drink alcoholic beverages

• She did not smoke or drink alcoholic beverages

On physical examination,she appeared in moderate respiratory distress.The right hemithorax was dull to percussion and the vocal fremitus was markedly diminished. Shifting dullness was present on abdominal exam

• On physical examination, she appeared in moderate respiratory distress. The right hemithorax was dull to percussion and the vocal fremitus was markedly diminished. Shifting dullness was present on abdominal exam

She had 2+pitting edema up to her shins bilaterally

• She had 2+ pitting edema up to her shins bilaterally

A chest X-ray revealed a large right pleural effusion

• A chest X-ray revealed a large right pleural effusion

The combination of ascites and right-sided pleural effusion in a patient with cirrhosis raised the possibility of a hepatic hydrothorax

• The combination of ascites and right-sided pleural effusion in a patient with cirrhosis raised the possibility of a hepatic hydrothorax