title: Primary pulmonary hypertension developing 11 years after a splenorenal shunt for portal hypertension in hepatic cirrhosis.
abstract: OBJECTIVE
  To describe a patient with pulmonary and portal hypertension and to review the pathogenesis and management of this condition.
  
  
  METHODS
  A 22-year-old woman with portal hypertension and liver cirrhosis who later developed pulmonary hypertension.
  
  
  METHODS
  The patient received antibiotic therapy and underwent a splenectomy and proximal splenorenal shunt for portal hypertension. She later received hydralazine, digoxin and warfarin for pulmonary hypertension.
  
  
  METHODS
  After undergoing a splenorenal shunt the patient made a good recovery. However, she later developed pulmonary hypertension and died after undergoing a hysterectomy and a bilateral salpingo-oophorectomy.
  
  
  CONCLUSIONS
  The concomitant development of portal and pulmonary hypertension in the same patient has a poor prognosis. The treatment available for patients with these conditions is unsatisfactory and most patients eventually die as a result of cardiovascular disease. Cardiopulmonary and liver transplantation should be considered in suitable patients.
authors.affiliation: Gastrointestinal and Liver Service, Royal Infirmary, Edinburgh University Medical School, UK.
authors.forename: H A
authors.initials: HA
authors.lastname: Shah
authors.forename: J
authors.initials: J
authors.lastname: Piris
authors.forename: N D
authors.initials: ND
authors.lastname: Finlayson
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications* / Q000601:surgery*; D006976:Hypertension, Pulmonary / Q000209:etiology*; D008103:Liver Cirrhosis / Q000150:complications*; D013164:Splenorenal Shunt, Surgical; D013997:Time Factors