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Chylothorax is a rare condition that results from thoracic duct disruption with malignant and nonmalignant etiologies manifesting as a pleural effusion. Typically, chylothorax in the setting of cirrhosis is associated with the migration of chylous ascites. We present the case of a 64-year-old male with prior liver transplant who presented with new-onset transudative chylothorax without chylous ascites who responded to transjugular intrahepatic portosystemic shunt revision, diuresis, and serial thoracentesis.

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Article Synopsis
  • Intra-abdominal pressure (IAP) is often ignored in clinical assessments but significantly affects organ function in patients with acute decompensated heart failure (ADHF).
  • A study of 30 ADHF patients found that 63.3% had intra-abdominal hypertension (IAH) upon admission, which was linked to poorer diuretic response and reduced urine output.
  • Findings suggest that even patients without abdominal symptoms can experience high IAP, which is correlated with diuretic resistance, highlighting the need for better understanding of IAP's role in treatment plans.
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Most episodes of acute heart failure (AHF) are characterized by increasing signs and symptoms of congestion, manifested by edema, pleura effusion and/or ascites. Immediately and repeatedly administered intravenous (IV) loop diuretics currently represent the mainstay of initial therapy aiming to achieve adequate diuresis/natriuresis and euvolemia. Despite these efforts, a significant proportion of patients have residual congestion at discharge, which is associated with a poor prognosis.

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