Document Detail


Pulmonary oedema after therapeutic ascitic paracentesis: a case report and literature review of the cardiac complications of cirrhosis.
MedLine Citation:
PMID:  19801941     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In this study, we describe the development of acute pulmonary oedema and cardiac arrest after therapeutic ascitic paracentesis, in a gentleman with decompensated liver cirrhosis. There was no previous history of cardiorespiratory symptoms or disease. Postmortem examination revealed oedematous and congested lungs with bilateral pleural effusions; in addition, the right heart was dilated and congested. Micronodular cirrhosis was present with histological features of alpha1 antitrypsin deficiency. This is the first study of acute cardiac decompensation after large volume paracentesis. Owing to the postmortem findings, underlying asymptomatic cardiorespiratory disease may have been present. Cirrhosis is associated with cardiovascular complications including cirrhotic cardiomyopathy, portopulmonary hypertension and hepatopulmonary syndrome which may manifest or worsen under situations of haemodynamic stress. This report thus raises the question whether routine screening for cardiovascular abnormalities is warranted in patients with decompensated cirrhosis, particularly before the procedures such as paracentesis that impose significant haemodynamic strain.
Authors:
Abhishek Sharma; Andrew Fletcher; George R Lipscomb
Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  European journal of gastroenterology & hepatology     Volume:  22     ISSN:  1473-5687     ISO Abbreviation:  Eur J Gastroenterol Hepatol     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-11     Completed Date:  2010-03-12     Revised Date:  2010-07-20    
Medline Journal Info:
Nlm Unique ID:  9000874     Medline TA:  Eur J Gastroenterol Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  241-5     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology, Royal Bolton Hospital, Lancashire, Bolton BL4 0JR, UK.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Ascites / etiology,  physiopathology,  therapy*
Autopsy
Cardiomyopathies / etiology
Electrocardiography
Fatal Outcome
Heart Arrest / etiology*,  physiopathology
Heart Failure / diagnosis,  etiology*,  physiopathology
Hemodynamics
Humans
Liver Cirrhosis / complications*,  physiopathology
Male
Multiple Organ Failure / etiology
Paracentesis / adverse effects*
Pleural Effusion / etiology
Pulmonary Edema / etiology*,  radiography
Comments/Corrections
Comment In:
Eur J Gastroenterol Hepatol. 2010 Aug;22(8):1024   [PMID:  20631544 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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