Hepatischer Hydrothorax ohne Aszites

A case of hepatic hydrothorax without clinical ascites is reported. The diagnosis was confirmed by intraperitoneal injection of ^99mTc-tin colloid: scintigraphic images taken between 5 min and 18 h p.i. demonstrated a oneway transdiaphragmatic flow into the pleural cavity. The therapy consisted of diuretic treatment, pleural drainage and chemical pleurodesis, and resulted in prompt clinical improvement.

Zusammenfassung

Wir berichten über einen Patienten mit rechtsseitigem hepatischen Hydrothorax ohne Nachweis eines Aszites. Die Diagnose wurde nach intraperitonealer Injektion von ^99mTc-Zinn-Kolloid gestellt: szintigraphische Aufnahmen zwischen 5 min und 18h p.i. zeigten den transdiaphragmalen Übertritt des markierten Kolloids in den Pleuraraum. Neben einer medikamentösen Therapie mit Diureticis wurden wiederholte Pleurapunktionen und abschließend eine Pleurodese mittels Instillation von Tetrazyklinen durchgeführt. Nach schneller Rekonvaleszenz konnte der Patient wenige Tage später entlassen werden.

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