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Dunbar Syndrome and hypoxic hepatitis: An Unusual Presentation

Open Journal of Gastroenterology 2024年第6期14卷 226-232页

作者： Hajar Cherkaoui Ismail Chaouech Yousra El Abidi Haroun Robleh Asmae Lamine Maria Lahlali Nada Lahmidani Amine Mekkaoui Mounia Elyousfi Dafr Allah Benajah Adil Ibrahimi Mohammed El Abkari Nizar Bouardi Mohammed Maaroufi Hakima Abid Department of Gastroenterology University Hospital Hassan II Fez Morocco Faculty of Medicine and Pharmacy Fez Morocco Department of Radiology University Hospital Hassan II Fez Morocco

hypoxic hepatitis, also known as ischemic hepatitis, is characterized by acute hepatocellular injury due to inadequate oxygen delivery to the liver. Celiac trunk stenosis can lead to hepatic ischemia and subsequent liver damage. We present the case of an 81-year-old patient with a history of hypertension, ischemic heart disease, hypothyroidism, and biliary lithiasis, who developed hypoxic hepatitis secondary to Dunbar syndrome and a stenosis of the superior mesenteric artery. The patient improved symptoms and liver function tests with conservative management, including intravenous fluids and supportive care. Long-term management involved continued antiplatelet therapy and statins, with consideration of further interventions for celiac trunk stenosis. This case underscores the importance of recognizing Dunbar syndrome as well as superior mesentery trunk stenosis as a potential cause of hypoxic hepatitis. It highlights the need for multidisciplinary management in such cases.

关键词： Dunbar Syndrome hypoxic hepatitis Stenosis of Mesentery Artery

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COVID-19 and liver injury: An ongoing challenge

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World Journal of Gastroenterology 2023年第2期29卷 257-271页

作者： Ioanna Papagiouvanni Serafeim-Chrysovalantis Kotoulas Athanasia Pataka Dionisios G Spyratos Konstantinos Porpodis Afroditi K Boutou Georgios Papagiouvannis Ioanna Grigoriou Christos Vettas Ioannis Goulis Fourth Department of Internal Medicine Aristotle University of ThessalonikiThessaloniki 54642ThessalonikiGreece Intensive Care Unit Hippokration General HospitalThessaloniki 54642Greece Department of Respiratory Medicine G Papanikolaou HospitalResp Failure UnitAristotle University of ThessalonikiThessaloniki 57001Greece Pulmonary Department Aristotle University of ThessalonikiThessaloniki 57001Greece Pulmonary Department G Papanikolaou HospitalResp Failure UnitAristotle University of ThessalonikiThessaloniki 54642Greece Department of Pharmacy School of Health SciencesFrederick UniversityNicosia 1036Cyprus Respiratory Failure Clinic Papanikolaou General HospitalThessloniki 57001Greece Fourth Department of Internal Medicine Hippokration General HospitalThessaloniki 54642Greece

The new coronavirus severe acute respiratory syndrome coronavirus 2(SARSCoV-2)was identified in December 2019,in Wuhan,*** virus was rapidly spread worldwide,causing coronavirus disease 2019(COVID-19)*** COVID-19 is presented,usually,with typical respiratory symptoms(i.e.,dyspnea,cough)and fever,extrapulmonary manifestations are also *** injury is a common feature in patients with COVID-19 and ranges from mild and temporary elevation of liver enzymes to severe liver injury and,even,acute liver *** pathogenesis of liver damage is not clearly defined;multiple mechanisms contribute to liver disorder,including direct cytopathic viral effect,cytokine storm and immune-mediated hepatitis,hypoxic injury,and druginduced liver *** with underlying chronic liver disease(i.e.,cirrhosis,non-alcoholic fatty liver disease,alcohol-related liver disease,hepatocellular carcinoma,etc.)may have greater risk to develop both severe COVID-19 and further liver deterioration,and,as a consequence,certain issues should be considered during disease *** aim of this review is to present the prevalence,clinical manifestation and pathophysiological mechanisms of liver injury in patients with SARS-CoV-2 ***,we overview the association between chronic liver disease and SARS-CoV-2 infection and we briefly discuss the management of liver injury during COVID-19.

关键词： COVID-19 Liver injury Cytokine storm hypoxic hepatitis Drug-induced liver injury Chronic liver disease

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