Hepatic Hydrothorax

 • Presents as right sided in 85% of cases

 • Fluid studies:

    - Pleural fluid/serum total protein ratio <0.5

    - Pleural fluid/serum LDH ratio < 0.6

    - Serum-to-pleural fluid albumin gradient > 1.1 g/dL

    - Protein <2.5 g/dL

    - pH > 7.4

 • Spontaneous bacterial pleural empyema may develop

 • Management: Diuresis Thoracentesis → ? TIPS, Liver transplant



- BWH Medicine Chiefs @BrighamChiefs



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