Successful surgical decortication for trapped lung in a patient with decompensated cirrhosis

Tripti R. Chopade, She-Yan Wong, David A. Sass, Scott W. Cowan, Nathaniel R. Evans, Jesse M. Civan


Hepatic hydrothorax affects 5% to 10% of patients with cirrhosis.  Infection of the pleural fluid may result in “trapped lung” physiology, which may jeopardize a patient’s candidacy for liver transplant, and thus compromise long-term survival. We report a case of a patient with decompensated cirrhosis whose transplant candidacy hinged on management of his trapped lung, and who underwent successful decortication.  In this particular case, surgical intervention was necessary not only as a “bridge” to transplant, but also because the patient’s short-term survival was limited by ongoing infection, which was refractory to medical therapy alone. In conclusion, our case illustrates that this high-risk surgery can be successfully carried out in the decompensated cirrhotic, but that further research is needed to ascertain the role for surgical decortication specifically for the purpose of “bridging” a patient to transplant.

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Case Reports in Internal Medicine

ISSN 2332-7243(Print)  ISSN 2332-7251(Online)

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