Which of the following clinical features is commonly associated with hepatic hydrothorax?

• A. Left-sided pleural effusion with no ascites
• B. Right-sided pleural effusion with ascites and signs of liver disease
• C. Bilateral effusions with no ascites
• D. Hemothorax with trauma

Answer: (B)

Hepatic hydrothorax occurs when ascitic fluid from cirrhosis-related ascites passes through small defects in the right hemidiaphragm into the pleural space. This creates a pleural effusion that is typically right-sided and accompanied by signs of liver disease and ascites. That combination—right-sided pleural effusion with ascites in a patient who has liver disease—best fits the mechanism, making it the correct description. Left-sided effusions without ascites don’t align with the usual diaphragmatic defects and portal hypertension-driven translocation, bilateral effusions without ascites don’t match the typical scenario, and a hemothorax from trauma is a different process involving blood in the chest.