Use of indwelling pleural catheter in a patient with refractory left-sided hepatic hydrothorax.

A female patient in her mid-50s presented with left-sided effusion in the context of decompensated cirrhosis secondary to alcoholic hepatitis. She had a pre-existing injury to her left hemidiaphragm following a fall 2 years previously, at which point she had also developed a left-sided effusion. The diagnosis of hepatic hydrothorax (HH) was made following pleural fluid aspiration. Recurrent thoracocentesis was not sufficient to manage the effusion and diuretic use was limited by hyponatraemia. An indwelling pleural catheter (IPC) was subsequently inserted to facilitate routine drainage and management in the outpatient setting. To our knowledge, this is the first instance of IPC insertion for HH in Ireland.