Original article
Hydrothorax as a complication of upper abdominal surgery

Hydrothorax may appear after operation in patients when pulmonary complications or acute inflammatory process in the abdominal cavity occur. This complication is rare. Drainage of the pleural cavity is also not necessary in every patient. The aim of the study was comparison of frequency of hydrothorax in patients after bariatric operations and patients with normal weight after selected operations in the upper abdomen. The analysis compared: 21 patients after surgical restrictive procedures operated on because of pathologic obesity (BMI >35 kg/m2), 26 patients after splenectomy and 31 patients operated because of perforated gastroduodenal ulcer. Among 21 bariatric patients, hydrothorax was diagnosed in 2 of them (in 1 of 2 persons with pneumonia and in 1 patient after iatrogenic splenectomy in whom subsequently subphrenic hematoma was recognised. Concerning these 3 pulmonary complications, hydrothorax required pleural cavity drainage in 2 of them (66%). None of the 26 patients subjected to splenectomy had hydrothorax diagnosed. Among 31 patients after perforated gastroduodenal ulcer surgery, pneumonia was recognized in 2 of them. In 1 of them liquid in the pleural cavity was present which did not require thorax tube placement. Another patient developed subphrenic abscess and concomitant pleural liquid which also did not demand pleural drainage. Collected data reveal that patients operated on because of pathologic obesity develop hydrothorax requiring pleural drainage more frequently than patients with normal weight subjected to surgery in the upper abdomen.