Acute lower limb ischemia as a triggering condition in hypoxic hepatitis: a study of five cases.

Details

Serval ID
serval:BIB_412E5ED70B0A
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Title
Acute lower limb ischemia as a triggering condition in hypoxic hepatitis: a study of five cases.
Journal
Journal of Clinical Gastroenterology
Author(s)
Henrion J., Deltenre P., De Maeght S., Peny M.O., Schapira M.
ISSN
1539-2031 (Electronic)
ISSN-L
0192-0790
Publication state
Published
Issued date
2011
Volume
45
Number
3
Pages
274-277
Language
english
Notes
Publication types: Case Reports ; Journal Article ; ReviewPublication Status: ppublish
Abstract
BACKGROUND/AIM: Acute centrilobular liver cell necrosis in hypoxic hepatitis (HH) occurs mainly in the setting of hemodynamic failure owing to cardiac failure, respiratory failure, and septic-toxic shock. Cases of HH were also reported under specific conditions such as heat stroke, grand mal seizure, obstructive sleep apnea, and complicated aortic aneurysm. In this study, we report 5 cases of HH occurring in the course of acute lower limb ischemia (ALLI). To the best of our knowledge, the association between HH and ALLI has not yet been reported.
METHODS: In a prospective and consecutive series of 142 cases of HH, we identified 5 cases (3.5%) in which ALLI was the triggering condition. The clinical, hemodynamic, and liver laboratory data of these 5 cases are reported. A review of the literature on liver injury observed in the case of ALLI is also made.
RESULTS: The 5 patients were 4 males and 1 female of mean age 63 years. All 5 had typical HH after ALLI. Four of them were in shock on admission. Arterial blood pH lower than 7.15 was observed upon admission in the 3 patients who died. Other potential causes of liver hypoxia were present in all patients. Urgent and efficient revascularization of the ischemic limb was a necessary condition for survival.
CONCLUSIONS: Acute lower limb ischemia should be added to the list of conditions able to trigger HH. In this particular setting, urgent revascularization of the ischemic limb seems to be a prerequisite for survival.
Keywords
Acute Disease, Adult, Aged, Anoxia/etiology, Anoxia/physiopathology, Female, Heart Failure/complications, Heart Failure/physiopathology, Hemodynamics, Hepatitis/etiology, Hepatitis/physiopathology, Humans, Ischemia/complications, Ischemia/physiopathology, Liver/blood supply, Liver/metabolism, Lower Extremity/physiopathology, Male, Middle Aged, Respiratory Insufficiency/complications, Respiratory Insufficiency/physiopathology, Shock, Septic/complications, Shock, Septic/physiopathology
Pubmed
Web of science
Create date
06/12/2013 11:09
Last modification date
03/03/2018 16:31
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