Hepatic vein stenosis and inferior vena cava stenosis in a patient with chronic obstructive pulmonary disease.
The case is presented of a patient with stenosis of the intrahepatic portion of the inferior vena cava and the terminal part of hepatic veins, a state manifesting itself in ascites resistant to treatment. The case was originally seen as decompensated cirrhosis of the liver. Once properly diagnosed, it was successfully treated with angioplasty and subsequent anticoagulation. After all the relevant hypercoagulation states potentially leading to IVC and hepatic vein stenosis were ruled out, the cause of the patient's stenosis could be traced to: 1. secondary polycythemia concomitant to severe pulmonary obstruction disease and 2. simultaneous corticosteroid therapy. This cause has not been described in literature before.
Bruha
Radan
R
4th Internal Department, General Teaching Hospital, Charles University Prague, Czech Republic. bruha@cesnet.cz
Petrtyl
Jaromir
J
Urbanek
Petr
P
Svestka
Tomislav
T
Maskova
Jana
J
Marecek
Zdenek
Z
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000800:Angioplasty, Balloon / Q000379:methods; D000925:Anticoagulants / Q000627:therapeutic use; D006502:Budd-Chiari Syndrome / Q000000981:diagnostic imaging* / Q000628:therapy*; D003131:Combined Modality Therapy; D003251:Constriction, Pathologic / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D035583:Rare Diseases; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000473:pathology*
D000305:Adrenal Cortex Hormones; D000925:Anticoagulants