Outcomes of patients with chest tube insertion for hepatic hydrothorax

Hepatol Int. 2009 Dec;3(4):582-6. doi: 10.1007/s12072-009-9136-z. Epub 2009 Aug 11.


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.