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KMID : 0383820090660010047
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Tuberculosis and Respiratory Diseases
2009 Volume.66 No. 1 p.47 ~ p.51
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A Case of Hepatopulmonary Syndrome in a Patient with Child-Pugh Class A Liver Cirrhosis
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Kim Jung-Sun
Kim Chang-Hwan
Kim Gye-Soo
Lim Dal-Soo
Hwang Heung-Kon
Ro Young-Moo
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Abstract
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Hepatopulmonary syndrome (HPS) is characterized by a defect in arterial oxygenation that’s induced by pulmonary vascular dilatation in the setting of liver disease. Some studies have shown the relationship between the presence of the HPS and the severity of liver disease, but there are only rare cases of HPS inpatient with Child-Pugh class A liver cirrhosis. We report here on a case of a 58 years-old male who suffered from progressive dyspnea for the previous few years. He was diagnosed with alcoholic liver cirrhosis 5 years previously. There was no significant abnormality on the chest radiograph and transthoracic echocardiography, but the arterial blood gas analysis revealed severe hypoxemia. Contrast-enhanced transesophageal echocardiograpy with agitated saline demonstrated a delayed appearance of microbubbles in the left cardiac chambers. Thus, he was finally diagnosed with HPS. This case suggests that we should consider HPS when a patient with compensated liver cirrhosis has unexplained dyspnea.
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KEYWORD
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Hepatopulmonary syndrome, Hypoxemia, Liver cirrhosis, Liver transplantation
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