Chronic Hypoxemia Inadvanced Liver Diseases: Hepatopulmonary Syndrome

Hepatopulmonary syndrome (HPS) is one of the pulmonary complications from liver disease with or without cirrhosis. The prevalence of HPS varies from 4% to 47% in patients with liver cirrhosis. We present a case of chronic progressive dyspnea in an 18-year-old man with a history of chronic liver disease. Diagnosing can be particularly challenging, especially in cases involving prolonged dyspnea and comorbidities. Following thorough investigations, the patient's condition was attributed to a rarer condition: severe hepatopulmonary syndrome. Contrast-enhanced echocardiography with agitated saline is the gold standard for diagnosing pulmonary vascular dilatation which is the hallmark of HPS. There is currently no medical therapy approved for HPS. Oxygen therapy is recommended for patients with severe hypoxemia.