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Hepatopulmonary syndrome

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Hepatology Textbook and Atlas

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Abstract

Recognition of a hepatopulmonary syndrome goes back over one hundred years (1884) to the detection of the triad: cyanosis, clubbed fingers and liver cirrhosis. (18). The same constellation of findings was described by A. Gilbert et al. in 1895 in juvenile patients suffering from hypertrophic biliary cirrhosis. • Reports on hypertrophic osteoarthropathy were published by A. A. Hijmans van den Bergh in 1901. • A. M. Snell detected hypoxaemia in chronic liver patients for the first time in 1935. (52) A right shift of the dissociation curve of oxyhaemoglobin was ascertained by A. Keys et al. in 1938. In the course of acute progressive liver failure, R. Rydell et al. (1956) also observed hypoxaemia; at autopsy, this patient showed intrapulmonary arteriovenous shunts. (45) Since then, there have been many reports on the detection of arteriovenous anastomoses in the lungs (further details in references 6, 7, 23). These arteriovenous shunts had already been attributed to vasoactive substances. The development of clubbed fingers was deemed to be the result of arteriovenous anastomoses in the tips of the fingers and the impact of reduced ferritin.

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(2008). Hepatopulmonary syndrome. In: Hepatology Textbook and Atlas. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-76839-5_18

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