Document Detail


A study of hepatopulmonary syndrome among patients of cirrhosis of liver and portal hypertension.
MedLine Citation:
PMID:  12866633     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Hepatopulmonary syndrome consists of a triad of hepatic dysfunction and/or portal hypertension, intrapulmonary vascular dilatations and hypoxemia. A study of hepatopulmonary syndrome among patients of cirrhosis of liver and portal hypertension was undertaken. METHODS: Thirty patients participated in this study. The diagnosis of cirrhosis of liver was confirmed by liver biopsy. Arterial blood gas analysis, pulmonary function tests, two-dimensional transthoracic air contrast echocardiography were undertaken in all the patients. Those patients in whom contrast echocardiogram showed intrapulmonary vascular dilatations were classified as the positive group while others were labelled as the negative group. RESULTS: Ten patients (33.33%) had a positive contrast echocardiogram; five (16.67%) of them were found to have PaO2<70 mmHg and were qualified for the diagnosis of hepatopulmonary syndrome (HPS); and other five (16.67%) with PaO2>70 mmHg were diagnosed as intrapulmonary dilatations syndrome (IPVDS). Five patients of HPS revealed significant P(A-a)O2 gradient and intrapulmonary shunts of moderate severity computed by a/A ratio. Cyanosis (p=0.001), clubbing (p=0.009) and orthodeoxia (p=0.0024) were significantly commoner in the five patients of hepatopulmonary syndrome. Presence of spider naevi was significantly related with the presence of intrapulmonary vascular dilatations. CONCLUSIONS: The study results showed presence of hepatopulmonary syndrome and intrapulmonary vascular dilatation syndrome among patients of portal hypertension. The presence of cyanosis, clubbing and orthodeoxia were found to be suggestive indicators of hepatopulmonary syndrome. Even though not very specific, spider naevi were found to be a useful clinical indicator for the presence of intrapulmonary vascular dilatations.
Authors:
H S Hira; Jaya Kumar; S K Tyagi; S K Jain
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Indian journal of chest diseases & allied sciences     Volume:  45     ISSN:  0377-9343     ISO Abbreviation:  Indian J Chest Dis Allied Sci     Publication Date:    2003 Jul-Sep
Date Detail:
Created Date:  2003-07-17     Completed Date:  2003-08-13     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7612044     Medline TA:  Indian J Chest Dis Allied Sci     Country:  India    
Other Details:
Languages:  eng     Pagination:  165-71     Citation Subset:  IM    
Affiliation:
Divisions of Pulmonary Medicine and Gastroenterology, Department of Medicine, Maulana Azad Medical College New Delhi, India.
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Hepatopulmonary Syndrome / diagnosis*,  etiology*,  therapy
Humans
Hypertension, Portal / complications*,  diagnosis*,  therapy
Liver Cirrhosis / complications*,  diagnosis*,  therapy
Male
Middle Aged

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