ABSTRACT
BACKGROUND Hepatopulmonary syndrome (HPS) is defined as an oxygenation defect induced by intrapulmonary vasodilation in patients with liver disease or portal hypertension. It is investigated in patients with liver cirrhosis and less frequently in those with portal hypertension without liver cirrhosis, as may occur in hepatosplenic schistosomiasis (HSS). OBJECTIVES To investigate the prevalence of HPS in patients with HSS, and to determine whether the occurrence of HPS is influenced by concomitant cirrhosis. METHODS We evaluated patients with HSS with or without concomitant liver cirrhosis. All patients underwent laboratory testing, ultrasound, endoscopy, contrast echocardiography, and arterial blood gas analysis. FINDINGS Of the 121 patients with HSS, 64 were also diagnosed with liver cirrhosis. HPS was diagnosed in 42 patients (35%) and was more frequent among patients with concomitant liver cirrhosis than in those without cirrhosis (42% vs. 26%), but the difference was not significant (p = 0.069). HPS was more common in those with spider naevi, Child-Pugh classes B or C and high model for end stage liver disease (MELD) scores (p < 0.05 each). MAIN CONCLUSIONS The prevalence of HPS was 35% in this study. The occurrence of liver cirrhosis concomitantly with HSS may have influenced the frequency of patients presenting with HPS.
Subject(s)
Humans , Male , Female , Middle Aged , Schistosomiasis mansoni/complications , Hepatopulmonary Syndrome/complications , Hepatopulmonary Syndrome/diagnosis , Hepatopulmonary Syndrome/epidemiology , Liver Cirrhosis/parasitology , Serial Cross-Sectional Studies , Prospective StudiesABSTRACT
Portal hypertensive gastropathy (PHG), a term used to describe the endoscopic appearance of gastric mucosa with a characteristic mosaic-like pattern, is characterized entities that can be associated with gastrointestinal blood loss in patients with portal hypertension. More than 65% of patients with portal hypertension from cirrhosis will develop PHG,however,it could also occur in the setting of non-cirrhotic portal hypertension. In patients with portal hypertension, the incidence of PHG was associated with severity of liver disease and the presence of both oesophageal and gastric varices. The exact etiology of PHG is not clearly defined, the diagnosis of PHG depends on endoscopy and histology, therapy of PHG is directed at lowering portal pressure by ?-blockers or shunt procedures.