Short communication, Note

Hepatopulmonary syndrome – commonly unrecognized complication in liver cirrhosis

Ivana Mikolašević ; Department of gastroenterology, Clinics for internal medicine, Clinical hospital centre Rijeka, Rijeka, Croatia
Željka Bagić ; Department of gastroenterology, Clinics for internal medicine, Clinical hospital centre Rijeka, Rijeka, Croatia
Sandra Milić ; Department of gastroenterology, Clinics for internal medicine, Clinical hospital centre Rijeka, Rijeka, Croatia
Marina Kurpis ; Department of pulmology, Clinics for internal medicine, Clinical hospital centre Rijeka, Rijeka, Croatia
Ante Matana ; Department of cardiology, Clinics for internal medicine, Clinical hospital centre Rijeka, Rijeka, Croatia
Melita Kukuljan ; Clinics for radiology, Clinical hospital centre Rijeka, Rijeka, Croatia
Damir Miletić ; Clinics for radiology, Clinical hospital centre Rijeka, Rijeka, Croatia
Davor Štimac ; Department of gastroenterology, Clinics for internal medicine, Clinical hospital centre Rijeka, Rijeka, Croatia

Abstract

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.

Keywords

diagnostic procedures; hepatopulmonary syndrome; liver cirrhosis; treatment

Hrčak ID:

53227

URI

https://hrcak.srce.hr/53227

Publication date:

7.6.2010.

Article data in other languages: croatian

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