Division of Trauma, Department of Emergency Medicine, Taipei-Veterans General Hospital, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2012 Aug;75(8):413-5. doi: 10.1016/j.jcma.2012.06.010. Epub 2012 Aug 3.
We report a successful treatment result in a rare case of hepatitis C virus-related cirrhosis, who had sustained hydrothorax after blunt thoracoabdominal trauma. This was a female patient with liver cirrhosis, Child-Turcotte-Pugh class A, without ascites before injury. She sustained blunt thoracoabdominal trauma with a left clavicle fracture dislocation and right rib fractures. There was no hemopneumothorax at initial presentation. However, dyspnea and right pleural effusion developed gradually. We inserted a chest tube to relieve the patient's symptoms, and the daily drainage amount remained consistent. Hepatic hydrothorax was confirmed by the intraperitoneal injection of radioisotope 99mTc-sulfur colloid that demonstrated one-way transdiaphragmatic flow of fluid from the peritoneal cavity to pleural cavities. Finally, the hydrothorax was treated successfully by minocycline-induced pleural symphysis. To the best of our knowledge, this is the first case of hepatic hydrothorax developed after thoracoabdominal trauma.
我们报告了一例罕见的丙型肝炎病毒相关性肝硬化病例的成功治疗结果，该患者在钝性胸腹外伤后持续发生胸腔积液。这是一名女性肝硬化患者，Child-Turcotte-Pugh 分级为 A 级，受伤前无腹水。她遭受了钝性胸腹外伤，伴有左锁骨骨折脱位和右肋骨骨折。初次就诊时没有血气胸。然而，逐渐出现呼吸困难和右侧胸腔积液。我们插入了一根胸腔引流管来缓解患者的症状，每日引流量保持一致。通过向腹腔内注射放射性核素 99mTc-硫胶体，证实了肝性胸腔积液的存在，该方法显示了液体从腹腔单向经横膈膜流入胸腔的过程。最终，通过米诺环素诱导的胸膜融合成功治疗了胸腔积液。据我们所知，这是首例在胸腹外伤后发生肝性胸腔积液的病例。
