Hepatopulmonary syndrome

Abstract

Hepatopulmonary syndrome (HPS) is one of the respiratory manifestation of liver disease. A reported incidence of 13-47% in cases of advanced liver disease. Impaired arterial oxygenation is the hallmark of HPS. Vascular abnormalities that are the intrapulmonary dilatations are thought to be the major cause of hypoxia and re the defining feature of HPS. Evaluation of HPS can be done by arterial blood gases, contrast-enhanced echocardiography, macroaggregated albumin scanning, pulmonary angiography and DLCo. A variety of medical agent such as almitrine, indomethacin, tamoxifen, B-blockers, plasma exchange, methylene blue and somatostatine analogues have been used in the treatment of HPS. The treatment modalities of HPS include: medical treatment, liver transplantation, transjuguler intrahepatic porto-systemic shunting (TIPS), embolisation and supplemental oxygen therapy.