Alawainati Mahmood, Khamis Jawad, Abdulla Muneer, Alsaeed Saeed
Department of Family Medicine, Ministry of Health, Manama, Bahrain.
Department of Medicine, Salmaniya Medical Complex, Manama, Bahrain.
Case Reports Hepatol. 2019 Jan 13;2019:6586478. doi: 10.1155/2019/6586478. eCollection 2019.
There are multiple aetiologies for dyspnea in patients with liver disease, including pneumonia, pulmonary embolism, hepatic hydrothorax, portopulmonary syndrome, and hepatopulmonary syndrome. The aim of this paper is to emphasize the importance of early diagnosis and management of hepatopulmonary syndrome.
We report a case of a 65-year-old male who was known to have chronic hepatitis C presented with one-year history of shortness of breath and cyanosis. The initial impression of pulmonary embolism was excluded by comprehensive diagnostic investigations. The correlation between the clinical picture and investigations raised the possibility of hepatopulmonary syndrome which was confirmed by contrast-enhanced transthoracic echocardiography.
High suspicion is required to diagnose hepatopulmonary syndrome in patients with liver disease and hypoxemia. Screening for this complication is appropriate in liver transplant candidates, and diagnosed patients should be evaluated extensively for liver transplant.
肝病患者出现呼吸困难有多种病因，包括肺炎、肺栓塞、肝性胸水、门肺综合征和肝肺综合征。本文的目的是强调肝肺综合征早期诊断和管理的重要性。
我们报告一例65岁男性，已知患有慢性丙型肝炎，有一年的呼吸急促和发绀病史。综合诊断检查排除了肺栓塞的初步印象。临床表现与检查结果之间的相关性增加了肝肺综合征的可能性，经对比增强经胸超声心动图证实。
对于患有肝病和低氧血症的患者，诊断肝肺综合征需要高度怀疑。对肝移植候选者进行这种并发症的筛查是合适的，确诊患者应进行全面的肝移植评估。
