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What is a Hydrothorax?

A hydrothorax is a medical condition where fluid accumulates in the pleural cavity, the space surrounding the lungs. This can cause shortness of breath and chest discomfort. It's often a symptom of underlying health issues, such as heart or kidney failure. Understanding its causes and treatments is crucial for managing symptoms. How might this condition affect you or your loved ones? Continue reading to learn more.
Solomon Branch
Solomon Branch

A hydrothorax is a medical condition wherein the pleural cavity, the space between the lungs and the chest, fills up with a pale, yellow and transparent fluid. This fluid is known as serous fluid, and normally serves the function of lubricating the lungs so they can move freely. The excess fluid causes the lungs to compress, and this leads to painful and difficult breathing, called dyspnea. This condition also leads to a lack of lung sounds when listening with a stethoscope, often the result of an underlying disorder.

There is a broader category, known as “pleural effusion”, of which a hydrothorax is one sub-category. Hydro means water and thorax means chest, so hydrothorax simply translates to “water in the chest.” The other categories include: hemothorax, blood in the chest; chylothorax, lymphatic fluid—chyme—in the chest; and pyothorax, also called empyema, which is pus in the chest. All of these terms refer to an excess of their particular fluid being in the chest, which is usually dangerous and indicative of an underlying disease or damage to the lungs.

Types of liver disease, including cirrhosis, which often causes hydrothorax.
Types of liver disease, including cirrhosis, which often causes hydrothorax.

The main cause of a hydrothorax is usually a problem with the liver known as cirrhosis. In cirrhosis of the liver, the liver function is decreased by scarring, nodule formation, and fibrosis, which are all the result of the liver repairing itself after the damage done by alcoholism, hepatitis B, and fatty-liver disease and other causes. It is unknown exactly how cirrhosis of the liver leads to hydrothorax, but it is believed that the malfunction of the liver causes an imbalance in the fluids of the body, and that excess can show up in the lungs.

During diagnosis, the physician will listen to the patient's lungs using a stethoscope.
During diagnosis, the physician will listen to the patient's lungs using a stethoscope.

Treating a hydrothorax presents several problems. The main difficulty is that most of the time, the hydrothorax is the result of the final stages of liver disease. It is not often recommended that the fluid be removed from the lung with a chest tube, as it will not stop the flow of excess fluid. The underlying cause has to be fixed, which usually means a liver transplant. Besides being risky, it is often difficult to find a donor for a liver transplant.

An ultrasound may help a physician to confirm a hydrothorax.
An ultrasound may help a physician to confirm a hydrothorax.

There is a another procedure, known as a transjugular intrahepatic portosystemic shunt (TIPS), that can be performed to fix a hydrothorax and is safer than a transplant. A TIPS procedure entails creating a passageway, or shunt, from the two main veins of the liver that bypass the scarring and allows the blood to flow smoothly through the liver. This reduces the overall pressure and lessens fluid build-up. Although it reduces the root of the problem, there is a danger that the liver itself will be damaged by the TIPS procedure.

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    • Types of liver disease, including cirrhosis, which often causes hydrothorax.
      By: peterjunaidy
      Types of liver disease, including cirrhosis, which often causes hydrothorax.
    • During diagnosis, the physician will listen to the patient's lungs using a stethoscope.
      By: aykuterd
      During diagnosis, the physician will listen to the patient's lungs using a stethoscope.
    • An ultrasound may help a physician to confirm a hydrothorax.
      By: nyul
      An ultrasound may help a physician to confirm a hydrothorax.
    • A hydrothorax is often the result of the final stages of liver disease.
      By: maya2008
      A hydrothorax is often the result of the final stages of liver disease.
    • The excess fluid in hydrothorax causes the lungs to compress, making breathing difficult.
      By: decade3d
      The excess fluid in hydrothorax causes the lungs to compress, making breathing difficult.