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Hepatic hydrothorax — SCE Respiratory MCQ

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ModeratePleural DiseaseHepatic hydrothoraxSCE Respiratory

A 58-year-old man with decompensated cirrhosis has recurrent right pleural effusion causing dyspnoea. Pleural fluid is transudative, cultures are negative and echocardiography is normal. Ascites is present. What is the most likely diagnosis?

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Correct answer: C — Hepatic hydrothorax

A recurrent right-sided transudative effusion in cirrhosis with ascites and no cardiac cause is typical of hepatic hydrothorax. Malignancy and empyema generally produce exudative fluid. Chylothorax is suggested by milky fluid and high triglycerides rather than a simple transudate.

Reference: BTS Pleural Disease Guideline 2023