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Updated: Nov 8, 2025

Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy
Published on: June 18, 2020
Acute Tension Hydrothorax in a Cirrhotic Patient With Hepatic Hydrothorax Without Ascites
Boniface Malangu1, Amjad Shaikh1
1Internal Medicine, Rutgers New Jersey Medical School, Newark, USA.
Abstract:
We describe a case of a 50-year-old man with alcohol cirrhosis status post transjugular intrahepatic portosystemic shunt (TIPS) who presented with dyspnea, refractory hepatic hydrothorax (HH), and no ascites who subsequently developed acute tension hydrothorax (TH). Urgent ultrasound-guided thoracentesis was performed with a significant improvement of symptoms. Further management consisted of a chest tube placement, subsequently removed with a plan for intermittent thoracentesis as needed, diuretic therapy, and salt restriction. HH occurs in 5%-10% of patients with cirrhosis, and TH in these patients is a rare entity that requires prompt recognition and drainage as it may be life-threatening.
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