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



(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.


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