RECURRENT EMERGENCY DEPARTMENT PRESENTATION - A CASE OF HEPATIC HYDROTHORAX

Introduction : In patients with advanced liver disease, dysregulation of extracellular fluid volume results in abnormal accumulation of fluid such as ascites, pleural effusion and edema .Hepatic hydrothorax occurs with accumulation of fluid (≥500ml) in patients with cirrhosis of liver in the absence of cardiopulmonary disease.The effusion which is transudate most commonly occurs in the right hemithorax .Treatment includes pharmacological–diuretics administration ,therapeutic thoracocentesis, operative interventions like TIPSS would be required in relapsed and refractory cases . We present a rare case of a male patient ,who presented to emergency with progressively worsening dyspnoea, having massive pleural effusion ,was later diagnosed to have hepatic hydrothorax with cirrhosis of liver with portal hypertension , was stabilized and treated in the emergency department .