TY - JOUR T1 - When common things aren't so common: A case report of hepatopulmonary syndrome JF - Clinical Medicine JO - Clin Med SP - 226 LP - 227 DO - 10.7861/clinmed.2021-0142 VL - 21 IS - 3 AU - Emma Keelan AU - Chris Ferguson AU - Rebecca Kerr Y1 - 2021/05/01 UR - http://www.rcpjournals.org/content/21/3/226.abstract N2 - A 60-year-old smoker with a history of liver cirrhosis and chronic obstructive pulmonary syndrome (COPD) presented with hypoxic respiratory failure. This was felt secondary to an exacerbation of COPD. Despite treatment, the patient required 10 L of oxygen to achieve saturations of 88% on ambulation. Interstitial lung disease, pulmonary emboli and pulmonary hypertension were excluded as potential aetiologies of hypoxia. Given the history of cirrhosis, hepatopulmonary syndrome was postulated. Contrast echocardiography suggested an extracardiac shunt; a technetium-99m macroaggregated albumin scan confirmed the diagnosis. ER -