Barry Mohammad, Al-Muhaidb Saud, Fathala Ahmed
Department of Radiology, Cardiothoracic Radiology and Nuclear Medicine divisions, King Faisal Specialist Hospital & Research Center, Riyadh 11211, Saudi Arabia.
Radiol Case Rep. 2020 Oct 8;15(12):2565-2568. doi: 10.1016/j.radcr.2020.09.053. eCollection 2020 Dec.
Constrictive pericarditis is well known but rare and commonly forgotten cause of ascites. Early diagnosis of constrictive pericarditis is difficult due to absence of typical cardiopulmonary signs and multiple vague symptoms and its insidious course. In this case report, we present a 61-year-old male referred for liver transplantation vs transjugular intrahepatic portosystemic shunt work-up for presumptive diagnosis of nonalcoholic steatohepatitis cirrhosis and refractory ascites. Comprehensive work-up before liver transplantation including liver biopsy, liver ultrasound, and Doppler, magnetic resonance imaging was not consistent with liver cirrhosis. Echocardiographic was suggestive of constrictive pericarditis, further work-up with right heart catheterization, cardiovascular magnetic resonance and multidetector cardiac computed tomography confirmed the diagnosis of constrictive pericarditis. Patient underwent surgical pericardiectomy, he reminded stable after surgery and did not require further paracentesis and discharged in stable condition.
缩窄性心包炎是一种众所周知但罕见且常被遗忘的腹水病因。由于缺乏典型的心肺体征、存在多种模糊症状以及病程隐匿，缩窄性心包炎的早期诊断较为困难。在本病例报告中，我们介绍了一名61岁男性，因疑似非酒精性脂肪性肝炎肝硬化和难治性腹水而被转诊进行肝移植或经颈静脉肝内门体分流术评估。肝移植前的全面检查，包括肝活检、肝脏超声和多普勒检查、磁共振成像，均与肝硬化不符。超声心动图提示缩窄性心包炎，通过右心导管检查、心血管磁共振成像和多排心脏计算机断层扫描进一步检查确诊为缩窄性心包炎。患者接受了心包切除术，术后情况稳定，无需进一步穿刺放腹水，出院时病情稳定。
