A 52-year-old woman with a history of cirrhosis due to chronic alcohole intake experiences worsening dyspnea. She has no other medical conditions. Vital signs are within normal limits. Physical examination shows normal jugular venous pressure, right-sided dullness to percussion and decreased breath sounds, normal heart sounds, and moderate-sized ascites. Chest x-ray reveals a large right-sided pleural effusion with no parenchymal lesions. Thoracentesis yields transudative fluid with normal cell counts. Which of the following is the most likely underlying mechanism of this patient's pulmonary findings?

Question

A 52-year-old woman with a history of cirrhosis due to chronic alcohole intake experiences worsening dyspnea.  She has no other medical conditions.  Vital signs are within normal limits.  Physical examination shows normal jugular venous pressure, right-sided dullness to percussion and decreased breath sounds, normal heart sounds, and moderate-sized ascites.  Chest x-ray reveals a large right-sided pleural effusion with no parenchymal lesions.  Thoracentesis yields transudative fluid with normal cell counts.  Which of the following is the most likely underlying mechanism of this patient's pulmonary findings?

Quizplus · Accepted Answer

Eductional Objective: Patients with cirrhosis complicated by abdominal ascites may develop a hepatic hydrothorax, which is a transudative, usually right-sided pleural effusion that results from passage of intraabdominal fluid into the chest cavity through small fenestrations in the diaphragm.

A 52-Year-Old Woman with a History of Cirrhosis Due to Chronic