European Journal of Biomedical and Pharmaceutical Sciences

TRANSITION FROM PORTOPULMONARY HYPERTENSION TO HEPATOPULMONARY SYNDROME IN A PATIENT WITH CIRRHOSIS: A RARE CLINICAL EVOLUTION

*Dr. B. Ravi Sankar, Dr. Arjunan MD, Dr. Marchwin Kingston MD, Dr. G. Rathnakumar MD

ABSTRACT

Porto-pulmonary hypertension (POPH) and hepatopulmonary syndrome (HPS) are distinct pulmonary vascular complications of chronic liver disease and portal hypertension. Despite sharing a common underlying hepatic pathology, they are characterized by opposing pathophysiological mechanisms. Their coexistence or sequential occurrence in the same patient is uncommon and remains poorly understood. Traditionally, these conditions have been regarded as mutually exclusive because of their contrasting pathophysiological mechanisms. However, rare reports suggest that both disorders may coexist or occur sequentially in the same patient. Such cases provide valuable insights into the complex pulmonary vascular alterations associated with chronic liver disease .We report a rare case of a patient with established Porto-pulmonary hypertension who subsequently developed hepatopulmonary syndrome six years later.

Keywords: Porto-pulmonary Hypertension; Hepatopulmonary Syndrome; Chronic Liver Disease; Portal Hypertension; Pulmonary Vascular Disease; Intrapulmonary Vascular Dilatation; Bubble Contrast Echocardiography; Liver Transplantation.