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CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2017; 01(01): 046-048
DOI: 10.1055/s-0037-1603566
Case Report
Indian Society of Vascular and Interventional Radiology

Hepatic Hydrothorax: The Conundrum and the Oxymoron

Sachin Kumar
1   Department of Pulmonary Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
,
Yashwant Patidar
2   Department of Radiodiagnosis, Institute of Liver and Biliary Sciences, New Delhi, India
,
Rakhi Maiwall
3   Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
› Author Affiliations
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Publication History

Publication Date:
28 July 2017 (online)

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Abstract

Hepatic hydrothorax (HH) is an infrequent but a well-known complication of portal hypertension. Medical management of this condition often fails, and there are no large randomized-controlled trials establishing the best treatment strategies. HH thus represents a formidable entity in the management of end-stage liver disease, and the only definitive treatment is liver transplantation. Despite documented ominous outcome, tube thoracostomy (TT) is still a widely practiced approach to HH mostly by the unaware primary care physician. This communication reports the occurrence of pleurosubcutaneous fistula as a presenting complication of TT in a patient with HH. TT should thus be avoided at all costs in this subset of patients because it is fraught with multiple complications. This report reinforces the importance of clinical education and awareness of these complications and outcomes of TT in a cirrhotic patient with HH.

Keywords

hepatic hydrothorax - chest tube removal - fistula - cirrhosis