Unveiling the Uncommon: Cirrhosis-Induced Pleural Effusion in the Absence of Ascites

<p>Hepatic hydrothorax is a well-recognized complication of advanced liver disease, typically occurring in patients with ascites. However, the presentation of hepatic hydrothorax in the absence of significant ascitic fluid is very uncommon and illustrates a unique diagnostic dilemma. This case report presents a 58-year-old female with a significant history of liver cirrhosis secondary to chronic Hepatitis B infection, who developed a massive right-sided pleural effusion lacking any concomitant ascites. The clinical presentation, diagnostic workup, and management of this case are discussed, highlighting the pathophysiological mechanisms underlying this unusual presentation. The case highlights the need for clinicians to maintain a high index of suspicion for hepatic hydrothorax in cirrhotic patients who exhibit respiratory symptoms, even in the absence of ascites, to ensure timely and appropriate management.</p>