Intraoperative pulmonary hypertension occurred in an asymptomatic patient with pre-existent liver cirrhotic and portal hypertension.
Portopulmonary hypertension (PPH) is clinically defined as the development of pulmonary arterial hypertension complicated by portal hypertension, with or without advanced hepatic disease. Physical signs may be absent in mild to moderate PPH and only appear in a hyperdynamic circulatory state. Similar signs of advanced liver disease can be observed in severe PPH, with ascites and lower extremity edema. Pulmonary hypertension is usually diagnosed after anesthetic induction during liver transplantation (LT). We present intraoperative pulmonary hypertension in a 41-year-old male patient with hepatic cirrhosis. Since this patient had no preoperation laboratory data supporting the diagnosis of pulmonary hypertension and was asymptomatic for a number of years, it was necessary to send him to the intensive care unit after operation. Further study should be focused on the diagnosis and treatment of pulmonary arterial hypertension in order to reduce its mortality.
Lu
Ling
L
Key Laboratory of Living Donor Liver Transplantation of Ministry of Public Health, Department of Liver Transplantation, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.
Zhang
Feng
F
Li
Xiang-Cheng
XC
Li
Guo-Qiang
GQ
Zhang
Chuan-Yong
CY
Wang
Xue-Hao
XH
D000328:Adult; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000503:physiopathology*; D006976:Hypertension, Pulmonary / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000601:surgery*; D016031:Liver Transplantation / Q000502:physiology*; D008297:Male