Hepatopulmonary syndrome diagnostic study of choice

Hepatopulmonary syndrome diagnostic triad. Diagram by Soroush Seifirad, MD.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2]

Diagnostic Study of Choice

Study of choice

There is no single diagnostic study of choice for the diagnosis of hepatopulmonary syndrome, but hepatopulmonary syndrome can be diagnosed based on history of liver disease, atrial blood gas analysis (widened alveolar-arterial oxygen gradient measurement); and imaging techniques reveal evidence of intra-pulmonary vascular dilation or arterio-venous communications that result in a right-to-left intrapulmonary shunt.

Investigations:

• Among the patients who present with clinical signs of hepatopulmonary syndrome, the [investigation name] is the most specific test for the diagnosis.
• Among the patients who present with clinical signs of hepatopulmonary syndrome, the [investigation name] is the most sensitive test for diagnosis.
• Among the patients who present with clinical signs of hepatopulmonary syndrome, the [investigation name] is the most efficient test for diagnosis.

The comparison of various diagnostic studies for hepatopulmonary syndrome

Test	Sensitivity	Specificity
Test 1	...%	...%
Test 2	...%	...%

[Name of test with higher sensitivity and specificity] is the preferred investigation based on the sensitivity and specificity

Diagnostic results

The following finding(s) on performing [investigation name] is(are) confirmatory for hepatopulmonary syndrome:

• [Finding 1]
• [Finding 2]

Sequence of Diagnostic Studies

The [name of investigation] must be performed when:

• The patient presented with symptoms/signs 1, 2, and 3 as the first step of diagnosis.
• A positive [test] is detected in the patient, to confirm the diagnosis.

OR

The various investigations must be performed in the following order:

• [Initial investigation]
• [2nd investigation]

Name of Diagnostic Criteria

It is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.

hepatopulmonary syndrome is primarily diagnosed based on clinical presentation. There are no established criteria for the diagnosis of hepatopulmonary syndrome.

OR

There is no single diagnostic study of choice for hepatopulmonary syndrome, though hepatopulmonary syndrome may be diagnosed based on [name of criteria] established by [...].

OR

The diagnosis of hepatopulmonary syndrome is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].

OR

The diagnosis of hepatopulmonary syndrome is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].

OR

hepatopulmonary syndrome may be diagnosed at any time if one or more of the following criteria are met:

• Criteria 1
• Criteria 2
• Criteria 3

OR

IF there are clear, established diagnostic criteria

The diagnosis of hepatopulmonary syndrome is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].

OR

The diagnosis of hepatopulmonary syndrome is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].

OR

The diagnosis of hepatopulmonary syndrome is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].

OR

IF there are no established diagnostic criteria

There are no established criteria for the diagnosis of hepatopulmonary syndrome.