Nilufer CETINER, Berna SAYLAN CEVIK, Engin TUTAR, Elif EROLU, Koray AK, Figen AKALIN

289

Constrictive pericarditis diagnosed following liver transplantation

Constrictive pericarditis is frequently diagnosed during evaluation of the patients for hepatosplenomegaly and easily missed if notconsidered in differential diagnosis. Herein, we present a patient diagnosed with constrictive pericarditis during his investigation forimpaired liver functions and right heart failure one year after liver transplantation.A thirteen-year-old boy presented with abdominal distention, dyspnea and fatigue. He had undergone liver transplantation due toliver failure in the previous year, and the symptoms had recurred in the last three months. Physical examination revealed normalheart sounds. Abdominal distention and ascites were present. Cardiothoracic index and pulmonary vascular markings were normalon chest X-ray. Echocardiography showed biatrial dilatation. Thickening of the pericardium with calcifications was demonstrated bythorax computerised tomography. High pulmonary wedge pressure and equalization of end-diastolic pressures were found duringcatheter-angiography. Pericardiectomy was performed, histopathology was compatible with chronic fibrinous pericarditis. Thepatient improved dramatically after surgery, the right heart failure findings resolved, and the liver graft functions turned to be normal.Constrictive pericarditis must be considered in differential diagnosis of hepatosplenomegaly, liver dysfunction and right heart failuresince surgical treatment is possible and lifesaving.
Keywords:

Constrictive pericarditis, Echocardiography, Liver transplantation, Pericardiectomy,

PDF

___

  • [1] Nishimura RA. Constrictive pericarditis in the modern era: a diagnostic dilemma. Heart 2001;86:619-23. doi: 10.1136/ heart.86.6.619.
  • [2] Bergman M, Vitrai J, Salman H. Constrictive pericarditis: A reminder of a not so rare disease. Eur J Intern Med 2006; 17: 457-64. doi: 10.1016/j.ejim.2006.07.006.
  • [3] Gotthardt DN, Weiss KH, Rathenberg V, Schemmer P, Stremmel W, Sauer P. Persistent ascites after liver transplantation: etiology, treatment and impact on survival. Ann Transplant 2013; 18: 378-83. doi: 10.12659/ AOT.883982.
  • [4] Szabó G, Schmack B, Bulut C, et al. Constrictive pericarditis: risks, aetiologies and outcomes after total pericardiectomy: 24 years of experience. Eur J Cardiothorac Surg 2013;44:1023-8. doi: 10.1093/ejcts/ezt138.
  • [5] Myers RB, Spodick DH. Constrictive pericarditis: clinical and pathophysiologic characteristics. Am Heart J 1999;138:219- 32. doi: 10.1016/s0002-8703(99)70105-5.
  • [6] Bezjak M, Kocman B, Jadrijević S, et.al. Constrictive pericarditis as a cause of refractory ascites after liver transplantation: A case report. World J Clin Cases 2019;7: 3266-70. doi: 10.12998/wjcc.v7.i20.3266.
  • [7] Runyon BA. AASLD Practice Guidelines Committee. Management of adult patients with ascites due to cirrhosis: an update. Hepatology 2009; 49: 2087-107. doi: 10.1002/ hep.22853.
  • [8] Lominadze Z, Kia L, Shah S, Parekh K, Levitsky J. Constrictive pericarditis as a cause of refractory ascites. ACG Case Rep J 2015; 2: 175-7. doi: 10.14309/crj.2015.46.
  • [9] Barry M, Al-Muhaidb S, Fathala A. A case report of constrictive pericarditis: a forgotten cause of refractory ascites. Radiol Case Rep 2020;15:2565-8. doi: 10.1016/j. radcr.2020.09.053.
  • [10] Celebi ZK, Keven K, Sengul S, et al. Constrictive pericarditis after renal transplantation: three case reports. Transplant Proc 2013; 45: 953-5. doi: 10.1016/j.transproceed.2013.02.060.
  • [11] Ling LH, Oh JK, Schaff HV, et al. Constrictive pericarditis in the modern era: evolving clinical spectrum and impact on outcome after pericardiectomy. Circulation 1999;100:1380-6. doi: 10.1161/01.cir.100.13.1380.
  • [12] Welch T.D, Ling L.H, Espinosa R.E, et al. Echocardiographic diagnosis of constrictive pericarditis Mayo Clinic criteria. Circulation: Cardiovascular Imaging 2014; 7:3 526-34. doi: 10.1161/CIRCIMAGING.113.001613.
  • [13] Howard JP, Jones D, Mills P, Marley R, Wragg A. Recurrent ascites due to constrictive pericarditis. Frontline Gastroenterol 2012; 3: 233-7. doi: 10.1136/flgastro-2012-100173.
  • [14] Chowdhury UK, Subramaniam GK, Kumar AS, et al. Pericardiectomy for constrictive pericarditis: a clinical, echocardiographic, and hemodynamic evaluation of two surgical techniques. Ann Thorac Surg 2006; 81: 522-9. doi: 10.1016/j.athoracsur.2005.08.009.
Marmara Medical Journal-Cover
  • ISSN: 1019-1941
  • Yayın Aralığı: Yılda 3 Sayı
  • Başlangıç: 1988
  • Yayıncı: Marmara Üniversitesi
Arşiv
Sayıdaki Diğer Makaleler

Kadir KUCUKCERAN, Mustafa Kursat AYRANCI

Hakki OLCULU, Kursat GUL, Seniyye Ulgen ZENGIN

Melekber CAVUS OZKAN, Omer SARAC

Hande KAYMAKCALAN, Hande ALP, Ahmet Okay CAGLAYAN, Okan GULBAHAR, Emine Nihal GOKMEN, Emrah NIKEREL

Erdi SOZEN, Tugce DEMIREL-YALCINER, Doga DAMLA DEMIR, Berkay OZNACAR, Nesrin KARTAL OZER

Hatice Ezgi BARIS, Hakan GUNHAN, Selda KUCUK, Fatma Nihal DURMUS KOCAASLAN, Perran BORAN

Murat Tugrul EREN, Hakan OZVERI

Coskun Ozer DEMIRTAS, Mesut KOLDAS, Metehan YILMAZ, Muhammed Zahid SAHIN, Muhammed Talha SOYKUVVET, Cigdem ATAIZI CELIKEL, Feyza GUNDUZ

Emine EKICI, Hatice IKIISIK, Handan ANKARALI, Gulay MANAV, Merve COLAK, Ezgi Hasret KOZAN

Sercin GUVEN, Ibrahim GOKCE, Ceren ALAVANDA, Neslihan CICEK, Ece BODUR DEMIRCI, Mehtap SAK, Serim PUL, Ozde Nisa TURKKAN, Nurdan YILDIZ, Pinar ATA, Harika ALPAY