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Vol. 42. Issue 9.
Pages 484-486 (September 2006)
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Vol. 42. Issue 9.
Pages 484-486 (September 2006)
Case Report
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Hepatopulmonary Syndrome in a Patient With Adenocarcinoma of the Colon Metastatic to the Liver and No Apparent Chronic Liver Disease
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Brian Vila Aulia,
Corresponding author
brianvila@mixmail.com

Correspondence: Dr. B. Vila. Hospital Clínico Universitario. Avda. Vicente Blasco Ibáñez, 17. 46010 Valencia. España
, Diego Pérez Garcíaa, Conrado Fernández Rodríguezb, Pilar Bañuls Poloa, Julio Marín Pardoa
a Servicio de Neumología, Hospital Clínico Universitario de Valencia, Valencia, Spain
b Servicio de Medicina Interna, Hospital Clínico Universitario de Valencia, Valencia, Spain
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Hepatopulmonary syndrome consists of a clinical triad: arterial blood deoxygenation, intrapulmonary vasodilation, and liver disease. Both acute and chronic cases of this syndrome have been reported, and the most common cause is cirrhosis. The principle disease mechanism is dilation of the pulmonary blood vessels causing alterations in gas exchange. Increased pulmonary production of nitric acid has been implicated as the primary pathogenic mechanism of vasodilation although it has also been associated with imbalance between vasodilators and vasoconstrictors. We describe the case of a patient with hepatopulmonary syndrome and adenocarcinoma of the colon with metastases to a previously healthy liver.

Key words:
Hepatopulmonary syndrome
Pulmonary vasodilation
Liver disease
Adenocarcinoma of the colon

El síndrome hepatopulmonar comprende una tríada clínica caracterizada por desoxigenación arterial, dilataciones vascu-lares intrapulmonares y hepatopatía. Se han descrito tanto ca-sos agudos como crónicos, y la causa más frecuente es la cirro-sis. El mecanismo fisiopatológico principal es la dilatación de los vasos pulmonares, que produce una alteración del inter-cambio gaseoso. Se ha implicado la mayor producción pulmo-nar de óxido nítrico como mecanismo patogénico principal de la vasodilatación, aunque también se ha relacionado el dese-quilibrio entre sustancias vasodilatadoras y vasoconstrictoras. Describimos un caso en el que se produjo un síndrome hepatopulmonar en un paciente afectado de un adenocarcinoma de colon con metástasis hepáticas en un hígado previamente sano.

Palabras clave:
Síndrome hepatopulmonar
Vasodilatación pulmonar
Hepatopatía
Adenocarcinoma de colon
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