Simultaneous right-sided volume overload and left-sided hypovolemia in a man with massive ascites and a hydrothorax.
case_report · Level V
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Abstract
The medical problems presented by an 83-yr-old man with hepatic amyloidosis complicated by massive ascites and a right hydrothorax are described. As a result of right atrial compression limiting right heart filling, the patient simultaneously experienced left-sided hypovolemia with renal and hepatic ischemia while manifesting signs of right-sided congestive failure. Only with a transjugular intrahepatic portosystemic shunt procedure, which eliminated the right atrial compression with resolution of the hydrothorax and ascites, was it possible to improve the other medical condition of this man.
Medical subject headings
- Ascites
- Blood Volume
- Hydrothorax
- Ischemia
- Kidney
- Liver