Case Report
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Dec 21, 2008; 14(47): 7260-7263
Published online Dec 21, 2008. doi: 10.3748/wjg.14.7260
Intraoperative pulmonary hypertension occurred in an asymptomatic patient with pre-existent liver cirrhotic and portal hypertension
Ling Lu, Feng Zhang, Xiang-Cheng Li, Guo-Qiang Li, Chuan-Yong Zhang, Xue-Hao Wang
Ling Lu, Feng Zhang, Xiang-Cheng Li, Chuan-Yong Zhang, Guo-Qiang Li, Xue-Hao Wang, Key Laboratory of Living Donor Liver Transplantation of Ministry of Public Health, Department of Liver Transplantation, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Author contributions: Lu L and Zhang F contributed equally to this work; Lu L, Zhang F, Li XC, Zhang CY, Li GQ, Wang XH performed the research; Lu L, Zhang F, Wang XH analyzed the data; Lu L and Zheng F wrote the paper.
Supported by The Special Funds for Jiangsu Clinic Center of Liver Surgery, No. 2007-1-06; the Project of Medical Leading Talents of Jiangsu Province, No. 2007-2-07
Correspondence to: Xue-Hao Wang, Key Laboratory of Living Donor Liver Transplantation of Ministry of Public Health, Department of Liver Transplantation, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China. zhangf@njmu.edu.cn
Telephone: +86-25-83718836 Fax: +86-25-83672106
Received: July 14, 2008
Revised: September 14, 2008
Accepted: September 21, 2008
Published online: December 21, 2008
Abstract

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 diagnosises 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 focued on the diagnosis and treatment of pulmonary arterial hypertension in order to reduce its mortality.

Keywords: Pulmonary hypertension; Liver transplantation; Portal hypertension; Cirrhosis; Hepatitis