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INTRODUCTION Hepatic hydrothorax is defined as a pleural effusion usually 500 ml, in patients with cirrhosis without cardiopulmonary disease . A reasonable estimate is that it ranges from 4 to 6%, and even up to 10% with advanced disease . In 85% of cases hepatic hydrothorax develops on the right side, 13% of cases occurring on the left side and 2% being bilateral. Hepatic hydrothorax may develop even in absence of ascites .