Korean J Gastroenterol.
2002 Nov;40(5):320-325.
A Clinical Analysis of Pleural Effusion in Liver Cirrhosis: Focused on Hepatic Hydrothorax and Spontaneous Bacterial Empyema
- Affiliations
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- 1Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea. songih@anseo.dankook.ac.kr
- 2Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Abstract
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BACKGROUND/AIMS: Ascites and spontaneous bacterial peritonitis (SBP) are well-known complications of cirrhosis, but hepatic hydrothorax (HH) and spontaneous bacterial empyema (SBE) have rarely been reported in Korea. The aims of this study were to determine the incidence and causes of pleural effusion that occurred in cirrhotic patients, and to analyze the clinical characteristics of HH and SBE.
METHODS
We performed a retrospective study through reviewing the medical records of the patients accompanied by pleural effusion among 1,724 cirrhotic patients.
RESULTS
Pleural effusion occurred in 6.0% of the cirrhotic patients. The most common cause of pleural effusion was parapneumonic effusion (50%), which was followed by HH (43%). The SBE occurred in 30.4% of the patients with HH who received thoracentesis. All cirrhotic patients with HH had ascites, but only part of the patients with SBE had SBP. All seven patients with SBE had decompensated cirrhosis, and three of these patients died of hepatic failure, sepsis, and variceal bleeding during admission.
CONCLUSIONS
HH and SBE are not rare complications of cirrhosis. The cirrhotic patients with SBE are characterized by the markedly decreased hepatic reserve and high mortality. Therefore, for cirrhotic patients with pleural effusion and suspected infection, active thoracentesis is recommended to explore the cause of effusion. Then, appropriate treatments according to causes of effusion are required.
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