An unusual cause of refractory hypoxemia in cirrhosis.

Abstract:

:Pulmonary gas exchange abnormalities and refractory hypoxemia cause myriad difficulties in patients with chronic liver disease. In addition to intrinsic cardiopulmonary diseases and hepatopulmonary syndrome, some unusual pathophysiological mechanisms in patients with portosystemic collaterals might contribute to hypoxemia. We report the clinical presentation of an unusual portosystemic anatomic shunt that permits venous admixture with oxygenated blood, causing hypoxemia that is refractory to the administration of supplemental oxygen, and recurrent hepatic encephalopathy. There has been no such report in the published literature. This case highlights the importance of keeping direct portopulmonary venous anastomosis in the differential diagnosis of oxygen-refractory hypoxemia and recurrent hepatic encephalopathy in patients with cirrhosis in the appropriate clinical context.

journal_name

Respir Care

journal_title

Respiratory care

authors

Patidar Y,Kumar S

doi

10.4187/respcare.03529

subject

Has Abstract

pub_date

2015-03-01 00:00:00

pages

e49-51

issue

3

eissn

0020-1324

issn

1943-3654

pii

respcare.03529

journal_volume

60

pub_type

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