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Outcomes of patients with chest tube insertion for hepatic hydrothorax

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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.

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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

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Authors and Affiliations

  1. Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA

    Eric S. Orman

  2. Division of Gastroenterology, University of Michigan Health System, 3912 Taubman Center, SPC 5362, Ann Arbor, MI, USA

    Anna S. F. Lok

Authors
  1. Eric S. Orman
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  2. Anna S. F. Lok
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Correspondence to Anna S. F. Lok.

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Orman, E.S., Lok, A.S.F. Outcomes of patients with chest tube insertion for hepatic hydrothorax. Hepatol Int 3, 582–586 (2009). https://doi.org/10.1007/s12072-009-9136-z

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  • DOI: https://doi.org/10.1007/s12072-009-9136-z

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