Craciun R, Mocan T, Procopet B, Nemes A, Tefas C, Sparchez M, Mocan LP, Sparchez Z. Pulmonary complications of portal hypertension: The overlooked decompensation. World J Clin Cases 2022; 10(17): 5531-5540 [PMID: 35979136 DOI: 10.12998/wjcc.v10.i17.5531]
Corresponding Author of This Article
Tudor Mocan, MD, PhD, Doctor, Senior Researcher, 3rd Medical Clinic, Department of Internal Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, 19-21 Croitorilor Street, Cluj-Napoca 400162, Romania. mocan_tudor@yahoo.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Rares Craciun, Tudor Mocan, Bogdan Procopet, Cristian Tefas, Zeno Sparchez, 3rd Medical Clinic, Department of Internal Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca 400162, Romania
Rares Craciun, Tudor Mocan, Bogdan Procopet, Cristian Tefas, Zeno Sparchez, Gastroenterology Clinic, "Prof. Dr. O. Fodor" Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca 400162, Romania
Andrada Nemes, Intensiv Care Unit I, Cluj County Emergency Hosptial, Cluj-Napoca 400006, Romania
Mihaela Sparchez, 2nd Paediatric Clinic, ”Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca 400126, Please enter the state or province, Romania
Lavinia-Patricia Mocan, Department of Histology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca 400349, Romania
Author contributions: Craciun R, Mocan T, Nemes A, and Tefas C performed the majority of the writing; Mocan LP and Sparchez M prepared the figures; Craciun R and Nemes A performed data acquisition and writing; Sparchez Z and Procopet B provided the input in writing the paper; Craciun R, Sparchez Z, and Procopet B designed the outline and coordinated the writing of the paper.
Conflict-of-interest statement: The authors declare no conflict of interest regarding the contents of the current manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tudor Mocan, MD, PhD, Doctor, Senior Researcher, 3rd Medical Clinic, Department of Internal Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, 19-21 Croitorilor Street, Cluj-Napoca 400162, Romania. mocan_tudor@yahoo.com
Received: January 16, 2022 Peer-review started: January 16, 2022 First decision: February 7, 2022 Revised: February 22, 2022 Accepted: April 9, 2022 Article in press: April 9, 2022 Published online: June 16, 2022 Processing time: 143 Days and 22.2 Hours
Abstract
The systemic nature of cirrhosis and portal hypertension has long been recognized, and the amount of data characterizing the interplay between each system is becoming ever so complex. Lung involvement was among the first described associated entities in cirrhosis, with reports dating back to the late nineteenth century. However, it appears that throughout the years, interest in the pulmonary complications of portal hypertension has generally faded, especially in contrast to other decompensating events, as expertise in this field has primarily been concentrated in highly experienced tertiary care facilities and liver transplantation centers. Despite affecting up to 10%-15% of patients with advanced liver disease and having a proven prognostic impact, hepato-pulmonary syndrome, porto-pulmonary hypertension, and hepatic hydrothorax are frequently misdiagnosed, mistreated, or misinterpreted. This lack of precision might adversely impact patient care, referral to expert centers, and, ultimately, liver disease-related mortality and successful transplantation odds. The present minireview aims to increase awareness of the pulmonary complications of chronic liver disease by providing a brief overview of each of the three entities. The paper focuses on the essential theoretical aspects, addressing the most critical knowledge gaps on the one hand and, on the other hand, critically discussing one key issue for each complication.
Core Tip: There is an increasing interest in the systemic involvement associated with chronic liver disease and portal hypertension. There are three main pulmonary complications of chronic liver disease: Hepato-pulmonary syndrome, porto-pulmonary hypertension, and hepatic hydrothorax. Despite being recognized for over a century, these entities are relatively understudied, forming a niche that typically becomes the appanage of tertiary care facilities and liver transplantation centers. This minireview aims to shed light on one hot topic for each entity with direct implications for day-to-day clinical practice.
