Hepatology International

, Volume 3, Issue 4, pp 582–586

Outcomes of patients with chest tube insertion for hepatic hydrothorax

Original Article

DOI: 10.1007/s12072-009-9136-z

Cite this article as:
Orman, E.S. & Lok, A.S.F. Hepatol Int (2009) 3: 582. doi:10.1007/s12072-009-9136-z
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Abstract

Purpose

Case reports and small case series have reported a high rate of complications associated with chest tube placement for hepatic hydrothorax. We describe the in-hospital and 3-month outcomes of patients who have had this procedure.

Methods

A retrospective medical record review was performed of all patients admitted to a tertiary care center over a 10-year period with a chest tube placed for hepatic hydrothorax. Demographic data and outcomes were collected and analyzed.

Results

Seventeen patients were identified; 12 were taking diuretics and 8 were taking multiple diuretics at the time of admission. MELD score was 14 (range = 7–34). During hospitalization, 16 had at least 1 and 12 had more than 1 complications. The most common complications were acute kidney injury (n = 11), pneumothorax (n = 7), and empyema (n = 5). Two patients died during the index admission and four others within 3 months of that admission. Six of seven patients who received TIPS survived.

Conclusions

Chest tube insertion for hepatic hydrothorax carries significant morbidity and mortality, with questionable benefit.

Keywords

Hepatic hydrothoraxChest tubeCirrhosisAscitesAcute kidney injury

Abbreviations

ALT

Alanine aminotransferase

AST

Aspartate aminotransferase

ICD

International classification of diseases

INR

International normalized ratio

MELD

Model for end-stage liver disease

TIPS

Transjugular intrahepatic portosystemic shunt

Copyright information

© Asian Pacific Association for the Study of the Liver 2009

Authors and Affiliations

  1. 1.Department of Internal MedicineUniversity of MichiganAnn ArborUSA
  2. 2.Division of GastroenterologyUniversity of Michigan Health SystemAnn ArborUSA