Thoracic complications of liver cirrhosis: radiologic findings.
Patients with chronic liver disease exhibit various cardiovascular and pulmonary complications. Hepatopulmonary syndrome results in dyspnea due to intrapulmonary arteriovenous shunting and ventilation-perfusion mismatch. Portopulmonary hypertension occurs in patients with portal hypertension. Intrathoracic portosystemic collateral vascular pathways develop in patients with portal hypertension to allow decompression of the portal vein into the systemic circulation. Hepatic hydrothorax may develop in patients with cirrhosis and ascites. Massive necrosis of the liver from any cause may be associated with acute hypoxic respiratory failure, necessitating ventilatory support. Bacterial infection is common in cirrhotic patients because of a compromised host defense system. Hepatocellular carcinoma may produce hematogenous lung metastases, intrathoracic lymph node metastases, direct intracardiac extension, and pulmonary embolism. Interferon therapy for treatment of chronic active hepatitis C may disturb cellular immune activation in some patients and contribute to the onset and progression of sarcoidosis. Awareness of the various thoracic manifestations in chronic liver disease can be helpful for making a differential diagnosis and planning proper management.
Kim
Yoon Kyung
YK
Department of Radiology, School of Medicine, Ewha Womans University, 911-1 Mokdong Yangcheon-gu, Seoul 158-710, Korea.
Kim
Yookyung
Y
Shim
Sung Shine
SS
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000000981:diagnostic imaging; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D003097:Collateral Circulation; D003937:Diagnosis, Differential; D005260:Female; D020065:Hepatopulmonary Syndrome / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D006876:Hydrothorax / Q000000981:diagnostic imaging / Q000209:etiology; D006975:Hypertension, Portal / Q000000981:diagnostic imaging / Q000209:etiology; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging / Q000209:etiology; D008103:Liver Cirrhosis / Q000150:complications / Q000000981:diagnostic imaging*; D008113:Liver Neoplasms / Q000150:complications / Q000000981:diagnostic imaging; D008171:Lung Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012128:Respiratory Distress Syndrome / Q000000981:diagnostic imaging / Q000209:etiology; D012507:Sarcoidosis / Q000150:complications / Q000000981:diagnostic imaging