HEPATIC HYDROTHORAX WITHOUT DIAPHRAGMATIC DEFECT - AN ORIGINAL SURGICAL-TREATMENT

A 58-year-old woman with a long history of well-compensated postnecrot ic cirrhosis with acute massive ascites and right-sided pleural effusi on was admitted. The injection of colorant and radioactive material in to the peritoneal cavity didn't show up any passage through the diaphr agm. After resuscitation therapy and insertion of abdominal and chest tube, effusions rapidly and massively re-accumulated. A LeVeen periton eovenous shunt was inserted as an emergency measure owing to hepatoren al syndrome. Ascites completely resolved but pleural effosion was cont inuously and severly recharged. A Denver inverted shunt was subcutaneo usly inserted from pleural to peritoneal cavity. After operation CPAP was applied and pump device activated; pleural effusion gradually disa ppeared clearing completely the pleural space. The patient was dischar ged on the 10th postoperative day; her general condition and laborator y test have remained satisfactory up to one year without ascites and p leural effusion.