Kratko priopćenje

Hepatopulmonary syndrome – commonly unrecognized complication in liver cirrhosis

Ivana Mikolašević ; Zavod za gastroenterologiju, Klinika za internu medicinu, Klinički bolnički centar Rijeka, Rijeka, Hrvatska
Željka Bagić ; Zavod za gastroenterologiju, Klinika za internu medicinu, Klinički bolnički centar Rijeka, Rijeka, Hrvatska
Sandra Milić ; Zavod za gastroenterologiju, Klinika za internu medicinu, Klinički bolnički centar Rijeka, Rijeka, Hrvatska
Marina Kurpis ; Zavod za pulmologiju, Klinika za internu medicinu, Klinički bolnički centar Rijeka, Rijeka, Hrvatska
Ante Matana ; Zavod za kardiologiju, Klinika za internu medicinu, Klinički bolnički centar Rijeka, Rijeka, Hrvatska
Melita Kukuljan ; Klinika za radiologiju, Klinički bolnički centar Rijeka, Rijeka, Hrvatska
Damir Miletić ; Klinika za radiologiju, Klinički bolnički centar Rijeka, Rijeka, Hrvatska
Davor Štimac ; Zavod za gastroenterologiju, Klinika za internu medicinu, Klinički bolnički centar Rijeka, Rijeka, Hrvatska

Sažetak

Aim: Hepatopulmonary syndrome (HPS), a pulmonary complicati on of liver cirrhosis, is the triad of liver disease, arterial hypoxemia and intrapulmonary vascular dilatation. Prevalence may be up to 47%, but in clinical practi ce it is rarely recognized and diagnosed. We present the case of HPS in a pati ent with liver cirrhosis and respiratory simptomatology and emphasise the importance of early recogniti on of HPS because of timely and adequate therapy approach. Case report: The pati ent was a 54-year-old male with liver cirrhosis (Child Pugh C 10) and dyspnea. Clinically (dyspnea) and biochemically (arterial hypoxemia, ortodeoxia) our presumpti ve diagnosis was HPS. Early diagnosis was established by applying contrast echocardiography, lung MSCT and CT pulmonary angiography. Discussion and conclusion: It is necessary to recognize HPS as a complication in liver cirrhosis and to verify it by using proper diagnostic methods. Diagnostics of HPS include detailed
anamnesis and physical examination, blood gas analysis, chest x-ray, contrast echocardiography, lung MSCT, lung perfusion scinti graphy (99m-Tc macro aggregated albumin lung perfusion scan) and CT pulmonary angiography in doubtful cases. Various trials evaluating drug effi ciency have been performed, but no medicati on has been found suitable for HPS treatment. Orthotopic liver transplantati on (OLT) is the only potential curative method.

Ključne riječi

diagnostic procedures; hepatopulmonary syndrome; liver cirrhosis; treatment

Hrčak ID:

53227

URI

https://hrcak.srce.hr/53227

Datum izdavanja:

7.6.2010.

Podaci na drugim jezicima: hrvatski

Posjeta: 3.986 *