Intrathoracic ascites

Journal of Hepatology 34 (2001) 483

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Intrathoracic ascites

A 63-year old woman with chronic HCV-related liver disease presented with abdominal distension. Abdominal ultrasound examination revealed hepatomegaly with a nodular liver pro®le, coarse echo-pattern and a moderate amount of peritoneal ¯uid. Posteroanterior and lateral chest ®lms showed a smooth, well-de®ned opacity located in the right hemithorax, lying anteriorly and obliterating the right cardiophrenic angle (upper ®gures). A body CT-scan revealed a small right pleural effusion and a peritoneal sac through the right foramen of Morgagni. This peritoneal sac was not occupied by parts of liver, bowel or omentum. Instead, it was exclusively ®lled with ascitic ¯uid (lower ®gures). Restriction of dietary sodium intake and oral diuretic therapy were prescribed and the patient was discharged one week later. Julio Delgado Department of Hematology, Hospital Universitario La Paz, Universidad AutoÂnoma de Madrid, Po. Castellana, 261, 28046, Madrid, Spain Jorge Gomez-Cerezo Department of Internal Medicine, Hospital Universitario La Paz, Universidad AutoÂnoma de Madrid, Po. Castellana, 261, 28046, Madrid, Spain 0168-8278/01/$20.00 q 2001 European Association for the Study of the Liver. Published by Elsevier Science B.V. All rights reserved. PII: S 0168-827 8(00)00081-7