Post-surgical shunt hepatopulmonary syndrome in a case of non-cirrhotic portal hypertension
| Autor: | Abdaul Kareem M. Sandokji, Eric M. Yoshida, Alan Weiss, Urs P. Steinbrecher, Stephen W. C. Chung, Charles H. Scudamore, Siegfried R. Erb, Paul Champion, Lindsay S. Machan, Andrzed K. Buczkowski, Paul D. Hannam |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Liver transplantation Liver disease Postoperative Complications Hypertension Portal Humans Portasystemic Shunt Surgical Medicine Respiratory function Hepatopulmonary syndrome Hepatology business.industry Liver Diseases Respiratory disease Gastroenterology medicine.disease Pulmonary hypertension Liver Transplantation Shunt (medical) Surgery Portal hypertension business Hepatopulmonary Syndrome |
| Zdroj: | European Journal of Gastroenterology & Hepatology. 11:1425-1428 |
| ISSN: | 0954-691X |
| DOI: | 10.1097/00042737-199912000-00015 |
| Popis: | Hepatopulmonary syndrome, a consequence of significant liver disease and portal hypertension, is thought to be secondary to the effects of vasoactive substances, normally inactivated in the liver, on the pulmonary vasculature. We report a patient with preserved hepatic function who underwent a decompressive surgical porto-systemic shunt for non-cirrhotic portal hypertension. This patient developed hepatopulmonary syndrome with dyspnoea and oxygen desaturation 2 years post-surgical shunt. Over the next 7 years, the patient's respiratory function became increasingly impaired although hepatic function remained preserved. Because of the hypothesized role of porto-systemic shunting in the aetiology of this syndrome, the surgical shunt was successfully reversed angiographically. No improvement in dyspnoea or oxygen saturation occurred and liver transplantation was undertaken. Six months post-transplant, the patient has decreased his oxygen requirements and is free of dyspnoea. Our experience supports the causal role of porto-systemic shunting in the pathogenesis of hepatopulmonary syndrome but suggests that merely decreasing the extent of porto-systemic shunting is not beneficial. Liver transplantation remains the only reliable therapeutic modality available to these patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|