Outcomes of patients with chest tube insertion for hepatic hydrothorax
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- Orman, E.S. & Lok, A.S.F. Hepatol Int (2009) 3: 582. doi:10.1007/s12072-009-9136-z
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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.
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.
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.
Chest tube insertion for hepatic hydrothorax carries significant morbidity and mortality, with questionable benefit.
KeywordsHepatic hydrothorax Chest tube Cirrhosis Ascites Acute kidney injury
International classification of diseases
International normalized ratio
Model for end-stage liver disease
Transjugular intrahepatic portosystemic shunt