Abstract
Objective:To determine clinical characteristics, causes and outcomes of pleural complications in cirrhotic patients.
Methods. One hundried cirrhotic patients were studied. All patients underwent chest x ray, abd. & chest sonography or CT to detect the existence of pl. complications. PF wasanalysied. The clinical and laboratory data from All patients were studied.
Results: Pl. effusion is the common findings in cirrhotic patients followed by Pyopneumothorax then Pneumothorax. Most common cause of pleural effusion was hepatic hydrothorax; (HH) followed by SBE, &empyema . The incidence of SBE was15% in cirrhotics and 18.8% in cirrhotics with hydrothorax. Fifteen patients had SBE, 66.7%of these SBE was associated with SBP.The microorganisms identified in PF were E.coli in 4, Strept. in 6, Staphyl. in 10, K. pneumoniae in 3, and 1 with Pseudomonas. Patients with SBE had a higher Child-Pugh score, lower serum albumin, prolonged proth. time, lower PF protein, and higher rate of associated SBP than patients with sterile hydrothorax. There was no statistically significant relation between amount of ascites, Child-Pugh classification and amount of eff.. Shortness of breath (90%), cough (46%), fever (56%), abdominal pain (48) and altered mental status (25%) are the most common symptoms. The mortality rate was 28%.
Conclusions. The most common cause of pl. effusion in hepatic Patients was H.hydrothorax followed by SBE .Patients with, a higher Child–Pugh score, low PF protein, or SBP are predisposed to SBE. Thoracentesis should be performed in cirrhotic patients with pl. eff. when infection is suspected or clinical deterioration occurs. SBE & empyema is associated with high mortality.
- © 2014 ERS