[Pseudosurgical acute abdomen syndrome in primary pulmonary hypertension].
The case is reported of a 49-year-old chronic alcoholic woman, who presented with severe pulmonary arterial hypertension (PAH) mimicking as an acute abdomen. She was admitted with right-sided hypochondrial abdominal pain and hepatomegaly, with a moderate jaundice. On admission to intensive care unit, she had an arterial blood pressure of 110/70 mmHg, a heart rate of 100 b.min-1, and a respiratory rate of 36 c.min-1. An electrocardiogram showed sinus rhythm and right-sided heart failure. Whilst breathing 6 l.min-1 oxygen, her arterial blood gases were: PaO2 47 mmHg PaCO2 29 mmHg. Severe PAH was confirmed by measuring her mean pulmonary arterial pressure, which was 46 mmHg, whilst her pulmonary wedge pressure was 7 mmHg. Hepatic function was also altered: total bilirubin 41 mumol.l-1, alkaline phosphatase 145 UI.l-1 and gamma glutamyl transferase 1 340 UI.l-1. She developed arterial hypotension, which did not respond to increasing doses of isoproterenol. She died on the third day. Necropsy confirmed the diagnosis of primary PAH, with acute "cardiac liver".
Lefebvre
M C
MC
Service d'Urgences Respiratoires et Réanimation Médicale, Hôpital Calmette, Lille.
Durocher
A
A
Saulnier
F
F
Wattel
F
F
D000006:Abdomen, Acute / Q000209:etiology*; D000437:Alcoholism / Q000150:complications; D006328:Cardiac Catheterization; D005260:Female; D006439:Hemodynamics; D006529:Hepatomegaly / Q000209:etiology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D007565:Jaundice / Q000209:etiology; D008875:Middle Aged; D016278:Ventricular Function, Right
Syndrome douloureux abdominal pseudochirurgical lors d'une hypertension artérielle pulmonaire primitive.