Clin Ultrasound.  2016 May;1(1):54-59. 10.18525/cu.2016.1.1.54.

Cardiogenic Liver Cirrhosis Due to Prosthetic Tricuspid Valve Obstruction Presented with Suspicions of Malignant Neoplasm

• Yang HS
• Kwon SY

• KMID: 2555397
• DOI: http://doi.org/10.18525/cu.2016.1.1.54

Abstract

A 37 year old female was referred for suspected carcinomatosis peritonei with abdominal distension aggravated for 2 months. Her past medical history was complicated by cardiac double-valve replacement 20 years ago, with no medications for the last 5 years. Transthoracic echocardiography revealed a dilated inferior vena cava (IVC) and hepatic vein, suggesting cardiogenic liver cirrhosis (LC) caused by a prosthetic tricuspid valve obstruction. Subsequent tricuspid valve re-replacement showed an organized thrombus and foreign body reaction with suture materials. Intractable ascites resolved soon after the operation. Four years later, she was again referred for a suspicious hepatocellular carcinoma on an abdominal computed tomography along with an alpha-fetoprotein of 39.5 ng/mL. It turned out to be a post-miscarriage period. Subsequent abdominal ultrasounds revealed cardiogenic LC without space-occupying lesions. Cardiogenic LC should be considered in LC with elevated jugular venous pressure and a dilated IVC on ultrasound--early diagnosis is important to manage a correctable underlying heart disease.

Keyword

Liver cirrhosis; Heart valve prosthesis; Echocardiography; 간경화; 인공심장판막; 심장 초음파