[Thoracocentesis in patients with pleural effusion and chronic alcoholic liver disease]

Joel Armando Loeza-Irigoyen, Yolando Muñoz-Guzmán, Carlos Pérez-Guzmán, Israel Gutiérrez-Mendoza
Revista Médica del Instituto Mexicano del Seguro Social 2008, 46 (4): 453-8

BACKGROUND: chronic alcoholic liver disease (EHAC) associates to recurrent pleural effusion. Generally thoracocentesis is not performed for considering this fluid a trasudate. Our objective was to determine the usefulness of thoracocentesis and causes of recurrent pleural effusion.

METHODS: we analyzed samples of pleural fluid of patients with chronic alcoholic liver disease, recurrent pleural effusion and respiratory failure. Blood tests, chest x-rays and pleural fluid analyses were evaluated.

RESULTS: we included 27 cases. Mean age of patients was >60 year old, mean evolution time of liver disease was approximately 4 years. 55.6% were exudates and 44.4% trasudates. Causes of recurrent pleural effusion were portal hypertension in 12 (44.4%) cases. In patients with exudate, the origin was infectious in 8 (29.6%) cases; in 4 (14.8%) the cause was malignancy; one more with pulmonary embolism, and in other two patients the cause was not identified.

CONCLUSIONS: we found that more than half of patients with chronic alcoholic liver disease and recurrent pleural effusion was an exudate, thus thoracocentesis should be frequently performed in these patients.

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