Reversibl asite neden olan iskemik hepatit: Olgu sunumu
Ischemic hepatitis as a cause of reversible ascites: Case report
Özet
Iskemik hepatit, dolasim bozukluguna bagli hipotansif episodlar ve/veya primer karaciger dokusu kanlanmasinin azalmasina bagli olarak gelisen klinik bir tablo olup, ciddi düzeyde hipertransaminazemi ile karekterizedir. Klinik prezentasyon genellikle non-spesifik ve akut seyirli olup, asit gelisimi nadirdir. 70 yasinda konjestif kalp yetmezligi tanisi olan erkek hasta halsizlik, efor dispnesi, bulanti ve karinda siskinlik yakinmalari ile basvurdu. Hipertransaminazemi ve asit saptanmasi üzerine yapilan incelemelerde, akut eroziv gastrit sonrasi gelisen anemiye bagli olarak, varolan kalp yetmezligi tablosunun dekompanse oldugu ve sonucunda iskemik hepatit gelistigi anlasildi. Konservatif tedavi ile klinik tablo ve laboratuvar bulgulari düzeldi. Bu olgu dolayisiyla, iskemik hepatit etyopatogenezi ve klinik prezentasyonu tartisilmistir. Klinik pratikte iskemik hepatitin, reverzibl asit olusumuna yol açan nedenlerden biri oldugu unutulmamali dir.
Abstract
Ischemic hepatitis is a clinical entity which occurs due to hypotensive episodes and/or poor liver tissue perfusion and is characterized by marked transaminase elevations. Clinical presentation is usually in an acute and non-specific manner, while ascites is a rare finding. A 70-year-old male with congestive heart failure was admitted to the hospital with the complaints of fatigue, dyspnea on exertion, nausea and abdominal swelling. The investigations after the findings of hypertransaminasemia and ascites disclosed the diagnosis of ischemic hepatitis due to decompensated heart failure, which was a consequence of acute erosive gastritis-induced anemia. The clinical and laboratory features resolved promptly with conservative measures. Etiopathogenesis and clinical presentation of ischemic hepatitis are discussed with respect to the current case. In clinical practice, ischemic hepatitis should be kept in mind as a cause of reversible ascites.
