Dh. Vanthiel et al., SIMULTANEOUS RIGHT-SIDED VOLUME OVERLOAD AND LEFT-SIDED HYPOVOLEMIA IN A MAN WITH MASSIVE ASCITES AND A HYDROTHORAX, The American journal of gastroenterology, 90(3), 1995, pp. 478-481
The medical problems presented by an 83-yr-old man with hepatic amyloi
dosis complicated by massive ascites and a right hydrothorax are descr
ibed, As a result of right atrial compression limiting right heart fil
ling, the patient simultaneously experienced left-sided hypovolemia wi
th renal and hepatic ischemia while manifesting signs of right-sided c
ongestive failure. Only with a transjugular intrahepatic portosystemic
shunt procedure, which eliminated the right atrial compression with r
esolution of the hydrothorax and ascites, was it possible to improve t
he other medical condition of this man.