Ocorrência de síndrome hepatopulmonar em pacientes cirróticos candidatos a transplante de fígado

Macedo, Liana Gonçalves; Lopes, Edmundo Pessoa; Albuquerque, Maria de Fátima Pessoa Militão de; Markman-Filho, Brivaldo; Véras, Flávio Henrique Amaral Pires; Araújo, Ana Carolina Chiappetta Correia de; Ferraz, Álvaro Antônio Bandeira

doi:10.1590/s1806-37132010000400007

Cited by 9 publications

(6 citation statements)

References 25 publications

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“…Results were similar to those found by other Brazilian transplant centers showing that it is an economically viable procedure based upon the financial transfer from the Brazilian National Health Service (SUS). Macedo et al60 determined the occurrence of hepatopulmonary syndrome in cirrhosis patients who are candidates for liver transplantation and found a high prevalence of the syndrome, which however did not correlate with any of the variables analyzed. Matos et al49 present a series of 93 consecutive patients who had elective surgery for known gallbladder polyps, treated from January 2003 to December 2007 and claim that cholecystectomy is the appropriate surgical treatment for gallbladder polyps, when removal is warranted.…”

Section: Reviewmentioning

confidence: 99%

An overview of recently published medical papers in Brazilian scientific journals

Silva

Gomes

2011

Clinics

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A brief review intended as information to the readership of Clinics on papers recently published under various medical headings in Brazilian scientific journals recently indexed or about to be indexed in ISI-THOMSON Journal Citation Reports. Journals covered in this review are Acta Ortopédica Brasileira, Arquivos Brasileiros de Cardiologia, Jornal Brasileiro de Pneumologia, Revista Brasileira de Cirurgia Cardiovascular and Revista da Associação Médica Brasileira.

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Section: Reviewmentioning

confidence: 99%

An overview of recently published medical papers in Brazilian scientific journals

Silva

Gomes

2011

Clinics

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“…It is estimated that schistosomiasis affects 2.5–6 million Brazilians [2] and about 10% of them develop the hepatosplenic form, which is the main cause of portal hypertension in Northeastern Brazil [3]. Portal hypertension is responsible for a number of complications in patients with schistosomiasis, like esophageal varices, gastrointestinal bleeding or intrapulmonary vascular dilatation (IPVD) [4], [5].…”

Section: Introductionmentioning

confidence: 99%

Intrapulmonary Vascular Dilatation Evaluated by 99mTc-MAA Scintigraphy and Its Association with Portal Hypertension in Schistosomiasis

et al. 2014

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BackgroundPortal hypertension is responsible for various complications in patients with schistosomiasis, among them intrapulmonary vascular dilations (IPVD). In cirrhotic patients the presence of IPVD is a sign of poor prognosis, but in patients with hepatosplenic schistosomiasis (HSS) there are no studies assessing the significance of this change. The aim of this study was to evaluate the occurrence of IPVD through 99mTc-MAA scintigraphy in patients with HSS and its relationship with clinical, laboratory, endoscopic and ultrasound parameters.MethodsCross-sectional study evaluating 51 patients with HSS. Patients were diagnosed with IPVD when the brain uptake of 99mTc-MAA was higher than 6%. Subsequently, they were divided according to presence (G1) or absence (G2) of IPVD and variables were compared between groups.ResultsOverall, 51 patients with mean age of 56±12 years were assessed. IPVD was observed in 31 patients (60%). There was no statistically significant differences between groups when clinical, laboratory and endoscopic parameters were compared. Regarding ultrasound parameters, the splenic vein diameter was smaller in G1 (0.9±0.3 cm) compared to G2 (1.2±0.4 cm), p = 0.029.ConclusionIn patients with HSS, the occurrence of IPVD by 99mTc-MAA scintigraphy was high and was associated with lower splenic vein diameter, which can be a mechanism of vascular protection against portal hypertension. However, more studies are needed to determine the clinical significance of the early diagnosis and natural evolution of IPVD in this population.

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“…Non-physiological pulmonary shunts are frequently investigated through transthoracic contrast echocardiography (TTCE) in portal hypertension due to hepatic cirrhosis as part of the assessment for liver transplantation [20, 21]. In hereditary hemorrhagic telangiectasia this is performed to determine the grade of intensity with the aim of preventing neurological complications, but it has been poorly studied in patients with schistosomiasis [16].…”

Section: Introductionmentioning

confidence: 99%

Pulmonary shunts in severe hepatosplenic schistosomiasis: Diagnosis by contrast echocardiography and their relationship with abdominal ultrasound findings

et al. 2017

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BackgroundSchistosomiasis is endemic to several parts of the world. Among the species that affect humans, Schistosoma mansoni is one of the most common causes of illness. In regions where schistosomiasis mansoni is endemic, reinfection is responsible for the emergence of hepatosplenic schistosomiasis (HSS) with portal hypertension in about 10% of infected individuals. Regardless of its etiology, portal hypertension may bring about the formation of arteriovenous fistulas and pulmonary vascular dilation, thus constituting a pulmonary shunt and its presence has been associated with the occurrence of neurological complications. The objective of this study was to identify pulmonary shunt using TTCE in patients with HSS and esophageal varices, and to compare the abdominal ultrasound and endoscopy findings among patients with and without pulmonary shunt.Methodology/Principal findingsIn this case series, a total of 461 patients with schistosomiasis mansoni were prospectively evaluated using abdominal ultrasound and endoscopy and 71 presented with HSS with esophageal varices. Fifty seven patients remained in the final analysis. The mean age of the patients was 55 ± 14 years, and 65% were female. Pulmonary shunts were observed in 19 (33.3%) patients. On comparing the groups with and without pulmonary shunt, no significant differences were observed in relation to the abdominal ultrasound and endoscopic findings. When comparing the two subgroups with pulmonary shunts (grade 1 vs grades 2 and 3), it was observed that the subgroup with shunt grades 2 and 3 presented with a significantly higher frequency of an enlarged splenic vein diameter (>0.9 cm), and an advanced pattern of periportal hepatic fibrosis (P = 0.041 and P = 0.005, respectively). None of the patients with pulmonary shunts had severe neurological complications.Conclusions/SignificanceOur findings suggest that in HSS with esophageal varices the pulmonary shunts may be present in higher grades and that in this condition it was associated with ultrasound findings compatible with advanced HSS.

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Ocorrência de síndrome hepatopulmonar em pacientes cirróticos candidatos a transplante de fígado

Cited by 9 publications

References 25 publications

An overview of recently published medical papers in Brazilian scientific journals

An overview of recently published medical papers in Brazilian scientific journals

Intrapulmonary Vascular Dilatation Evaluated by 99mTc-MAA Scintigraphy and Its Association with Portal Hypertension in Schistosomiasis

Pulmonary shunts in severe hepatosplenic schistosomiasis: Diagnosis by contrast echocardiography and their relationship with abdominal ultrasound findings

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