Open AccessAn unusual cause of dyspnoea complicating right upper abdominal swelling
Author(s) -
S. K. Mandal,
Partha Pratim Chakraborty,
Rana Bhattacharjee,
Subhasis Roy Chowdhury,
Shounak Majumdar
Publication year - 2006
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v12.i25.4109
Subject(s) - medicine , ascites , inferior vena cava , liver abscess , respiratory distress , abscess , hepatopulmonary syndrome , abdominal pain , surgery , abdomen , liver function tests , radiology , cirrhosis , portal hypertension
A middle aged, non-addict male presented with right upper abdominal pain and swelling with respiratory distress. Examination revealed central cyanosis, bipedal pitting edema with prominent epigastric and back veins. Liver was enlarged, tender, spanned 20 cm without any splenomegaly or ascites. Other systems were clinically normal. Laboratory investigations showed polymorphonuclear leucocytosis with slightly deranged liver function. Abdominal ultrasonography showed an abscess in the right lobe of the liver with compressed inferior vena cava (IVC), middle and left hepatic veins. Arterial blood gas (ABG) documented hypoxia with orthodeoxia and air-contrast echocardiography was suggestive of an intrapulmonary shunt. A diagnosis of hepato-pulmonary syndrome (HPS) was made with near normal liver function secondary to amebic liver abscess. It reversed completely following successful treatment of the liver abscess.