Hepatic Hydrothorax: The Conundrum and the Oxymoron

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 o...

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Main Authors: Sachin Kumar, Yashwant Patidar, Rakhi Maiwall
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2017-04-01
Series:Journal of Clinical Interventional Radiology ISVIR
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1603566
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author Sachin Kumar
Yashwant Patidar
Rakhi Maiwall
author_facet Sachin Kumar
Yashwant Patidar
Rakhi Maiwall
author_sort Sachin Kumar
collection DOAJ
description 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.
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publisher Thieme Medical and Scientific Publishers Pvt. Ltd.
record_format Article
series Journal of Clinical Interventional Radiology ISVIR
spelling doaj-art-8542c51e8fb04d38a5dc86b9f8940a1b2025-08-20T01:58:20ZengThieme Medical and Scientific Publishers Pvt. Ltd.Journal of Clinical Interventional Radiology ISVIR2456-48692017-04-01010104604810.1055/s-0037-1603566Hepatic Hydrothorax: The Conundrum and the OxymoronSachin Kumar0Yashwant Patidar1Rakhi Maiwall2Department of Pulmonary Medicine, Institute of Liver and Biliary Sciences, New Delhi, IndiaDepartment of Radiodiagnosis, Institute of Liver and Biliary Sciences, New Delhi, IndiaDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, IndiaHepatic 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.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1603566hepatic hydrothoraxchest tube removalfistulacirrhosis
spellingShingle Sachin Kumar
Yashwant Patidar
Rakhi Maiwall
Hepatic Hydrothorax: The Conundrum and the Oxymoron
Journal of Clinical Interventional Radiology ISVIR
hepatic hydrothorax
chest tube removal
fistula
cirrhosis
title Hepatic Hydrothorax: The Conundrum and the Oxymoron
title_full Hepatic Hydrothorax: The Conundrum and the Oxymoron
title_fullStr Hepatic Hydrothorax: The Conundrum and the Oxymoron
title_full_unstemmed Hepatic Hydrothorax: The Conundrum and the Oxymoron
title_short Hepatic Hydrothorax: The Conundrum and the Oxymoron
title_sort hepatic hydrothorax the conundrum and the oxymoron
topic hepatic hydrothorax
chest tube removal
fistula
cirrhosis
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1603566
work_keys_str_mv AT sachinkumar hepatichydrothoraxtheconundrumandtheoxymoron
AT yashwantpatidar hepatichydrothoraxtheconundrumandtheoxymoron
AT rakhimaiwall hepatichydrothoraxtheconundrumandtheoxymoron