Hepatic Hydrothorax in the Background of Minimal or No Ascites: A Case Report

InvestigationsThe examination findings were corroborated by the chest X-ray, which showed the presence of pleural effusion in the right middle and lower zones (Fig. 1).Direct microscopy of the pleural fluid showed 150 cells/mL 3 with a neutrophilic predominance of 80%.The culture of the pleural fluid grew Pseudomonas aeruginosa.On biochemical analysis, glucose levels in the pleural fluid were 77.0 mg/dL, the pleural protein/serum protein ratio was <0.5, and the pleural lactate dehydrogenase (LDH)/serum LDH ratio was <0.6, suggesting the transudative nature of the fluid according to the modified light's criteria. 5 The biochemical analysis results have been summarized in Table 1.Ultrasonography (USG) of the abdomen showed a normal-sized liver with coarse echotexture a dilated portal vein (14 mm) and splenomegaly (13.8 cm), which were suggestive of CLD with portal hypertension (Fig. 2).Minimal ascites was noted, which could not