Hepatic Coma Secondary to Fontan Conduit Thrombosis.

Autor:	Cavaco JL; Department of Internal Medicine II, Centro Hospitalar Universitário Lisboa Norte, E.P.E., Lisbon, Portugal., Ferreira AR; Department of Internal Medicine II, Centro Hospitalar Universitário Lisboa Norte, E.P.E., Lisbon, Portugal., Jalles CA; Department of Internal Medicine II, Centro Hospitalar Universitário Lisboa Norte, E.P.E., Lisbon, Portugal., Lopes IM; Department of Internal Medicine II, Centro Hospitalar Universitário Lisboa Norte, E.P.E., Lisbon, Portugal., Braz A; Department of Internal Medicine II, Centro Hospitalar Universitário Lisboa Norte, E.P.E., Lisbon, Portugal., Pedro AO; Department of Internal Medicine II, Centro Hospitalar Universitário Lisboa Norte, E.P.E., Lisbon, Portugal., de Lacerda AP; Department of Internal Medicine II, Centro Hospitalar Universitário Lisboa Norte, E.P.E., Lisbon, Portugal.
Jazyk:	angličtina
Zdroj:	European journal of case reports in internal medicine [Eur J Case Rep Intern Med] 2023 Mar 27; Vol. 10 (4), pp. 003817. Date of Electronic Publication: 2023 Mar 27 (Print Publication: 2023).
DOI:	10.12890/2023_003817
Abstrakt:	Introduction: The Fontan procedure is used to treat congenital heart defects and has improved long-term survival. Long-term complications include liver disease due to congestive hepatopathy. Fontan-related cirrhosis can manifest with ascites, gastrointestinal bleeding and encephalopathy. Case Description: A 43-year-old man with history of Fontan surgery was admitted with COVID-19 pneumonia. There was rapid clinical and neurological deterioration, with coma and shock. CT imaging showed thrombosis of the Fontan conduit. The patient was successfully subjected to recanalization of the Fontan circulation, with progressive improvement of coma. Discussion: Fontan-associated liver disease is a major complication following the Fontan procedure. Clinicians must be aware of this pathology during patient follow-up. Learning Points: The Fontan procedure has improved the long-term survival of patients with single ventricle pathology.Fontan-associated liver disease is a result of haemodynamic changes associated with Fontan circulation; complications include hepatic encephalopathy and coma.Patients with Fontan circulation should be evaluated over time in order prevent and treat systemic complications. Competing Interests: Conflicts of Interests: The Authors declare that there are no competing interests. (© EFIM 2023.)
Databáze:	MEDLINE
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