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Key Clinical Message   We describe a challenging case of hepatic hydrothorax secondary to nonalcoholic steatohepatitis cirrhosis. Our management involved successfully treating the hydrothorax with a transjugular intrahepatic porto‐systemic shunt but having to manage the subsequent complication of hepatic encephalopathy. We conclude with a review of the available literature.

clinical case reports

Symptomatic hepatic hydrothorax successfully treated with transjugular intrahepatic portosystemic shunt (TIPS)–role of titration of portosystemic gradient reduction to avoid post‐TIPS encephalopathy