scholarly journals Hepatopulmonary Syndrome and Portopulmonary Hypertension: The Pulmonary Vascular Enigmas of Liver Disease

2020 ◽  
Vol 15 (S1) ◽  
Author(s):  
Michael J. Krowka
Keyword(s):  
Liver Disease ◽  
Hepatopulmonary Syndrome ◽  
Portopulmonary Hypertension

The lung in liver disease: hepatopulmonary syndrome and portopulmonary hypertension

2019 ◽  
pp. 262-277
Author(s):  
Sebastiano Emanuele Torrisi ◽  
Valentin Fuhrmann ◽  
Dirk Skowasch ◽  
Michael Kreuter
Keyword(s):  
Liver Disease ◽  
Hepatopulmonary Syndrome ◽  
Portopulmonary Hypertension

Hepatopulmonary syndrome as the first and only manifestation of cirrhosis in a patient with hypopituitarism

2021 ◽  
Vol 14 (9) ◽  
pp. e244805
Author(s):  
Eman Alabsawy ◽  
Yassen Serry ◽  
Sreelakshmi Kotha ◽  
Philip Berry ◽  
Giovanni Tritto
Keyword(s):  
Liver Disease ◽  
Fatty Liver Disease ◽  
Hepatopulmonary Syndrome ◽  
Progressive Dyspnoea ◽  
Alcoholic Fatty Liver ◽  
End Stage Liver Disease ◽  
Pituitary Dysfunction ◽  
Vascular Dilatation ◽  
End Stage ◽  
Alcoholic Fatty Liver Disease

Hepatopulmonary syndrome (HPS) is characterised by the development of intrapulmonary arteriovenous blood shunts and vascular dilatation with consequent hypoxaemia, usually in the context of end-stage liver disease (ESLD). The estimated incidence of HPS in ESLD has been reported to be 13%–47%. Chronic liver disease has been described in patients with hypothalamic–pituitary dysfunction, mainly in the form of non-alcoholic fatty liver disease due to metabolic syndrome, with occasional progression to cirrhosis. We report a challenging case of a 27-year-old man with a background of hypopituitarism with no known liver disease who presented with progressive dyspnoea and hypoxaemia and was eventually diagnosed with severe HPS.

scholarly journals Advances in Diagnostic Imaging of Hepatopulmonary Syndrome

2022 ◽  
Vol 8 ◽  
Author(s):  
Bi-Wei Luo ◽  
Zhi-Yong Du
Keyword(s):  
Liver Disease ◽  
Pulmonary Complication ◽  
Hepatopulmonary Syndrome ◽  
Pulmonary Angiography ◽  
Pulmonary Perfusion ◽  
Clinical Prognosis ◽  
Vascular Dilatation ◽  
Progressive Liver Disease ◽  
Poor Clinical Prognosis ◽  
Timely Treatment

Hepatopulmonary syndrome (HPS) is a serious pulmonary complication of progressive liver disease that leads to a poor clinical prognosis. Patients with HPS may develop acute respiratory failure, which requires intensive care and therapy. At present, the only effective treatment is liver transplantation; therefore, early diagnosis and timely treatment are of considerable significance. The three main features of HPS are liver disease, oxygenation disorder, and intrapulmonary vascular dilatation (IPVD). Diagnosing HPS is challenging due to the difficulty in detecting the presence or absence of IPVD. As such, imaging examination is very important for detecting IPVD. This paper reviews the imaging methods for diagnosing HPS such as ultrasound, dynamic pulmonary perfusion imaging, pulmonary angiography, and computed tomography.

Use of a Microbubble Contrast Agent in the Evaluation of Cirrhotic Patients for Hepatopulmonary Syndrome: Preliminary Assessment of a Novel Technique

Ultrasound ◽  
2005 ◽  
Vol 13 (2) ◽  
pp. 100-105
Author(s):  
J. M. Pilcher ◽  
R. J. Eckersley ◽  
A. K. P. Lim ◽  
N. Patel ◽  
C. L. Shovlin ◽  
...  
Keyword(s):  
Liver Disease ◽  
Pulse Oximetry ◽  
Hepatopulmonary Syndrome ◽  
Positive Contrast ◽  
Contrast Study ◽  
Novel Technique ◽  
Invasive Test ◽  
Contrast Enhanced ◽  
Contrast Enhanced Echocardiography ◽  
Positive Results

Hepatopulmonary syndrome (HPS) may cause profound symptomatic hypoxia in patients with chronic liver disease and can be an indication for liver transplantation. The diagnosis relies on the demonstration of intrapulmonary vascular dilatation (IVD) using either contrast-enhanced echocardiography or macro-aggregated lung perfusion scans. We sought to evaluate whether a novel technique using the microbubble agent, Echovist® (Schering AG) with Doppler intensitometry of the carotid artery would be able to identify patients who fulfilled the criteria for HPS. Contrast studies were performed in 18 patients with cirrhosis, examined in the supine and upright positions. Following injection of Echovist, continuous scanning of the common carotid was performed using grey-scale and spectral Doppler for 60 s. Positive studies were determined by online signal analysis of the Doppler signal (crackle-count). Supine and upright pulse oximetry was recorded on all patients, and formal lung function tests where clinically indicated. Two patients met the criteria for HPS. They had positive results on supine and upright scans, with an increased crackle-count when upright. Two patients had single, weakly positive results with normal pulse oximetry. No association was seen between a positive contrast study and the severity of liver disease. Contrast-enhanced carotid Doppler intensitometry is a relatively simple, non-invasive test that may help identify patients with IVD. Comparison with an established technique will be required in future trials to determine its accuracy and assess whether the crackle-count can reliably quantify the degree of IVD.

P023 Isolated intrapulmonary vascular dilatations in children with chronic liver disease without hepatopulmonary syndrome

2018 ◽  
Vol 50 (4) ◽  
pp. e367
Author(s):  
M. Caruso ◽  
T. Alterio ◽  
A. Pietrobattista ◽  
D. Liccardo ◽  
M. Basso ◽  
...  
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Hepatopulmonary Syndrome ◽  
Chronic Liver
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