Andrade R J, Martin-Palanca A, Fraile J M, Alcantara R, Carmona C, Medina M C, Muñoz V, Melgarejo F
Department of Gastroenterology, University Hospital School of Medicine, Málaga, Spain.
J Clin Gastroenterol. 1996 Jun;22(4):305-7. doi: 10.1097/00004836-199606000-00013.
Hepatic hydrothorax in the absence of clinical ascites (HHAA) is a somewhat rare complication in decompensated cirrhosis. Patients with HHAA have a congenital defect in the tendinous portion of the diaphragm allowing rapid leakage of ascites into pleural cavity because of the cyclical negative intrathoracic pressure. Although several therapeutic approaches, including peritoneovenous shunt and chemical or surgical pleurodesis, have been attempted in these patients the results are largely unsatisfactory. A poor-risk surgical cirrhotic woman who was also considered not suitable for liver transplantation underwent transjugular intrahepatic portosystemic shunt (TIPS) for palliation of HHAA. After TIPS procedure hydrothorax completely resolved. TIPS can offer an attractive alternative to standard therapy in cirrhotic patients with HHAA.
无临床腹水的肝性胸水（HHAA）是失代偿期肝硬化中一种较为罕见的并发症。HHAA患者在膈肌腱部存在先天性缺陷，由于胸腔内压力周期性负压，使得腹水迅速漏入胸腔。尽管已对这些患者尝试了多种治疗方法，包括腹腔静脉分流术以及化学或手术性胸膜固定术，但结果大多不尽人意。一名手术风险高且被认为不适合肝移植的肝硬化女性患者，接受了经颈静脉肝内门体分流术（TIPS）以缓解HHAA。TIPS术后胸水完全消退。对于患有HHAA的肝硬化患者，TIPS可为标准治疗提供一种有吸引力的替代方案。
