Constrictive pericarditis diagnosed following liver transplantation

Year 2021, , 335 - 338, 27.10.2021

Nilufer Cetıner Berna Saylan Cevık Engin Tutar Elif Erolu Koray Ak Figen Akalın

https://doi.org/10.5472/marumj.1012634

Abstract

Constrictive pericarditis is frequently diagnosed during evaluation of the patients for hepatosplenomegaly and easily missed if not
considered in differential diagnosis. Herein, we present a patient diagnosed with constrictive pericarditis during his investigation for
impaired 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 to
liver failure in the previous year, and the symptoms had recurred in the last three months. Physical examination revealed normal
heart sounds. Abdominal distention and ascites were present. Cardiothoracic index and pulmonary vascular markings were normal
on chest X-ray. Echocardiography showed biatrial dilatation. Thickening of the pericardium with calcifications was demonstrated by
thorax computerised tomography. High pulmonary wedge pressure and equalization of end-diastolic pressures were found during
catheter-angiography. Pericardiectomy was performed, histopathology was compatible with chronic fibrinous pericarditis. The
patient 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 failure
since surgical treatment is possible and lifesaving.

Keywords

Constrictive pericarditis, Echocardiography, Liver transplantation, Pericardiectomy

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