KUMJ | VOL. 22 | NO. 3 | ISSUE 87 | JULY-SEPTEMBER 2024
Prevalence of Hepatic Hydrothorax in Patients with Chronic Liver Disease Presenting in Tertiary Center of Nepal
Shankhadev A, KC S, Karki N, Sharma D, Pradhan P
Abstract: Background
Hepatic hydrothorax is a common cause of pleural effusion in chronic liver disease. It
is associated with poor outcome of the disease.
Objective
To study the prevalence of hepatic hydrothorax in patient with chronic liver disease.
Method
A hospital based prospective observational study conducted from July 15, 2022 to
July 15, 2023. Diagnostic thoracentesis was performed to the patients presenting
with pleural effusion at the time of admission. Chest x-ray was repeated at day 7 to
assess the outcome of the appropriate treatment.
Result
Out of 752 enrolled participants, 105 were diagnosed with pleural effusion. The
predominant cause was hepatic hydrothorax (80%), followed by tuberculosis (13.3%).
26.2% experienced spontaneous bacterial empyema. Most of the patients (74%)
were classified as Child-Pugh C score. The prevalence of hepatic hydrothorax was
11.17%. Among 84 patients with hepatic hydrothorax, the mean age was 49.42±11.93
years, with a male predominance (male to female ratio, 68:32). Hepatic hydrothorax
primarily occurred on the right side (78.6%), followed by left (15.5%) and bilaterally
(6%). Mild hepatic hydrothorax was most common (48.8%), followed by moderate
(31%) and massive (20.2%). About 65.5% were improved with treatment, while the
mortality rate was 34.52%. Renal causes were the most common cause of death,
accounting for 58.62% of mortalities.
Conclusion
Hepatic hydrothorax was prevalent in 11.17% of patients. It predominantly occurred
on right side, with advanced Child Pugh score and often associated with spontaneous
bacterial empyema (26.2%). The condition carried a mortality rate of 34.52%, with
renal causes accounting for the majority of deaths (58.62%). All pleural effusions in
chronic liver disease should undergo prompt evaluation because it is often associated
with various complications and carries high mortality rate.
Keyword : Ascites, Chronic liver disease, Hepatic hydrothorax, Prevalence, Spontaneous bacterial empyema, Tuberculosis
