Fetor hepaticus: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{SI}} | {{SI}} | ||
{{CMG}} | {{CMG}}; {{AE}} | ||
{{SK}} Breath of the dead; foetor hepaticus; hepatic foetor | {{SK}} Breath of the dead; foetor hepaticus; hepatic foetor | ||
==Overview== | ==Overview== | ||
'''Fetor hepaticus''' is a condition seen in [[portal hypertension]] where portosystemic shunting allows thiols to pass directly into the [[lung]]s. It is a late sign in [[liver failure]] and is one of the clinical features of [[hepatic encephalopathy]]. Other possible causes are the presence of [[ammonia]] and [[ketones]] in the breath. The [[breath]] has a [[sweet]], [[feces|fecal]] [[odor|smell]] to it. | '''Fetor hepaticus''' is a condition seen in [[portal hypertension]] where portosystemic shunting allows thiols to pass directly into the [[lung]]s. It is a late sign in [[liver failure]] and is one of the clinical features of [[hepatic encephalopathy]]. Other possible causes are the presence of [[ammonia]] and [[ketones]] in the breath. The [[breath]] has a [[sweet]], [[feces|fecal]] [[odor|smell]] to it. | ||
The compound [[dimethyl sulfide]] has been associated with it,<ref name="pmid18938115">{{cite journal |author=Van den Velde S, Nevens F, Van Hee P, van Steenberghe D, Quirynen M |title=GC-MS analysis of breath odor compounds in liver patients |journal=J. Chromatogr. B Analyt. Technol. Biomed. Life Sci. |volume=875 |issue=2 |pages=344–8 |date=November 2008 |pmid=18938115 |doi=10.1016/j.jchromb.2008.08.031 |url=http://linkinghub.elsevier.com/retrieve/pii/S1570-0232(08)00646-6}}</ref> raising the possibility of an objective noninvasive measure of liver failure. Furthermore, the volatile dimethyl sulfide is thought by some researchers to be the main contributor to the odor of fetor hepaticus.<ref>{{cite journal|last=Kaji|first=H|coauthors=Hisamura, M; Saito, N; Murao, M|title=Gas chromatographic determination of volatile sulfur compounds in the expired alveolar air in hepatopathic subjects.|journal=Journal of chromatography|date=May 1, 1978|volume=145|issue=3|pages=464–8|pmid=659533|doi=10.1016/s0378-4347(00)81377-8}}</ref><ref>{{cite journal|last=Tangerman|first=A|coauthors=Meuwese-Arends, MT; Jansen, JB|title=Cause and composition of foetor hepaticus.|journal=Lancet|date=Feb 19, 1994|volume=343|issue=8895|pages=483|pmid=7905979|doi=10.1016/s0140-6736(94)92729-4}}</ref> A secondary form of [[trimethylaminuria]] is also associated with liver failure, and it has been suggested that that [[trimethylamine]] is also a contributor to the odor of fetor hepaticus.<ref>{{cite journal|last=Mitchell|first=S|coauthors=Ayesh, R; Barrett, T; Smith, R|title=Trimethylamine and foetor hepaticus.|journal=Scandinavian journal of gastroenterology|date=May 1999|volume=34|issue=5|pages=524–8|pmid=10423071|doi=10.1080/003655299750026281}}</ref> | The compound [[dimethyl sulfide]] has been associated with it,<ref name="pmid18938115">{{cite journal |author=Van den Velde S, Nevens F, Van Hee P, van Steenberghe D, Quirynen M |title=GC-MS analysis of breath odor compounds in liver patients |journal=J. Chromatogr. B Analyt. Technol. Biomed. Life Sci. |volume=875 |issue=2 |pages=344–8 |date=November 2008 |pmid=18938115 |doi=10.1016/j.jchromb.2008.08.031 |url=http://linkinghub.elsevier.com/retrieve/pii/S1570-0232(08)00646-6}}</ref> raising the possibility of an objective noninvasive measure of liver failure. Furthermore, the volatile dimethyl sulfide is thought by some researchers to be the main contributor to the odor of fetor hepaticus.<ref>{{cite journal|last=Kaji|first=H|coauthors=Hisamura, M; Saito, N; Murao, M|title=Gas chromatographic determination of volatile sulfur compounds in the expired alveolar air in hepatopathic subjects.|journal=Journal of chromatography|date=May 1, 1978|volume=145|issue=3|pages=464–8|pmid=659533|doi=10.1016/s0378-4347(00)81377-8}}</ref><ref>{{cite journal|last=Tangerman|first=A|coauthors=Meuwese-Arends, MT; Jansen, JB|title=Cause and composition of foetor hepaticus.|journal=Lancet|date=Feb 19, 1994|volume=343|issue=8895|pages=483|pmid=7905979|doi=10.1016/s0140-6736(94)92729-4}}</ref> A secondary form of [[trimethylaminuria]] is also associated with liver failure, and it has been suggested that that [[trimethylamine]] is also a contributor to the odor of fetor hepaticus.<ref>{{cite journal|last=Mitchell|first=S|coauthors=Ayesh, R; Barrett, T; Smith, R|title=Trimethylamine and foetor hepaticus.|journal=Scandinavian journal of gastroenterology|date=May 1999|volume=34|issue=5|pages=524–8|pmid=10423071|doi=10.1080/003655299750026281}}</ref> | ||
==Historical Perspective== | |||
==Classification== | |||
==Pathophysiology== | |||
==Causes== | |||
==Differentiating {{PAGENAME}} from Other Diseases== | |||
==Epidemiology and Demographics== | |||
==Risk Factors== | |||
==Screening== | |||
==Natural History, Complications, and Prognosis== | |||
===Natural History=== | |||
===Complications=== | |||
===Prognosis=== | |||
==Diagnosis== | |||
===Diagnostic Criteria=== | |||
===History and Symptoms=== | |||
===Physical Examination=== | |||
===Laboratory Findings=== | |||
===Imaging Findings=== | |||
===Other Diagnostic Studies=== | |||
==Treatment== | |||
===Medical Therapy=== | |||
===Surgery=== | |||
===Prevention=== | |||
==See Also== | ==See Also== | ||
Revision as of 16:58, 19 July 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Synonyms and keywords: Breath of the dead; foetor hepaticus; hepatic foetor
Overview
Fetor hepaticus is a condition seen in portal hypertension where portosystemic shunting allows thiols to pass directly into the lungs. It is a late sign in liver failure and is one of the clinical features of hepatic encephalopathy. Other possible causes are the presence of ammonia and ketones in the breath. The breath has a sweet, fecal smell to it.
The compound dimethyl sulfide has been associated with it,[1] raising the possibility of an objective noninvasive measure of liver failure. Furthermore, the volatile dimethyl sulfide is thought by some researchers to be the main contributor to the odor of fetor hepaticus.[2][3] A secondary form of trimethylaminuria is also associated with liver failure, and it has been suggested that that trimethylamine is also a contributor to the odor of fetor hepaticus.[4]
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Fetor hepaticus from Other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications, and Prognosis
Natural History
Complications
Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Prevention
See Also
References
- ↑ Van den Velde S, Nevens F, Van Hee P, van Steenberghe D, Quirynen M (November 2008). "GC-MS analysis of breath odor compounds in liver patients". J. Chromatogr. B Analyt. Technol. Biomed. Life Sci. 875 (2): 344–8. doi:10.1016/j.jchromb.2008.08.031. PMID 18938115.
- ↑ Kaji, H (May 1, 1978). "Gas chromatographic determination of volatile sulfur compounds in the expired alveolar air in hepatopathic subjects". Journal of chromatography. 145 (3): 464–8. doi:10.1016/s0378-4347(00)81377-8. PMID 659533. Unknown parameter
|coauthors=ignored (help) - ↑ Tangerman, A (Feb 19, 1994). "Cause and composition of foetor hepaticus". Lancet. 343 (8895): 483. doi:10.1016/s0140-6736(94)92729-4. PMID 7905979. Unknown parameter
|coauthors=ignored (help) - ↑ Mitchell, S (May 1999). "Trimethylamine and foetor hepaticus". Scandinavian journal of gastroenterology. 34 (5): 524–8. doi:10.1080/003655299750026281. PMID 10423071. Unknown parameter
|coauthors=ignored (help)