A patient with cirrhosis and portal hypertension may develop a pleural effusion with little or no ascites.
Clinical features:
(1) cirrhosis with portal hypertension
(2) absence of primary cardiac or pulmonary disease
(3) large pleural effusion
(4) ascites may be present or absent
Pathophysiology:
(1) anatomic defect in the diaphragm between the peritoneal cavity and the pleural space with the effusion
(2) intra-abdominal pressure higher than intrapleural pressure
The hydrothorax may decrease and ascites increase during mechanical ventilation, since this increases the intra-thoracic pressure.
