Prevalence of spontaneous bacterial empyma in patients with hepatic hydrothorax

Abstract

Cirrhosis is defined as a chronic disease of the liver in which diffuse destruction and regeneration of hepatic parenchyma cells have occurred, and in which a diffuse increase in connective tissues has resulted in disorganization of the lobular and vascular architecture. The principal pathologic features of cirrhosis include hepatic parenchymal necrosis, regeneration, and scarring. Clinically, distortion of the vascular architecture causes the most serious complications, portal hypertension with resulting ascites, variceal hemorrhage, hypersplenism and hepatic hydrothorax (Shi et al., 2005). Hepatic hydrothorax is defined as significant pleural effusion (usually greater than 500 mL) in a cirrhotic patient, in the absence of underlying pulmonary or cardiac disease. The diagnosis of hepatic hydrothorax should be suspected in a patient with established cirrhosis and portal hypertension, presenting with pleural effusion, most commonly right sided. Hydrothorax is uncommon, and is found in 4–6% of all patients with cirrhosis and up to 10% in patients with decompensated cirrhosis. (Siddappa and Kar, 2009).