PMC6764030_01
Chest X-ray shows unilateral opacification in right lower lobe.
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Chest X-ray (Figure 1) and computed tomography scan (Figure 2) showed right-sided pleural effusion; thoracentesis revealed transudative fluid.
Computed tomography scan of chest showed findings consistent with right-sided
pleural effusion.
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Chest X-ray (Figure 1) and computed tomography scan (Figure 2) showed right-sided pleural effusion; thoracentesis revealed transudative fluid.
Enteroscopy reveals grade 1 esophageal varices.
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To evaluate the anemia and melena, the patient underwent colonoscopy and enteroscopy revealing ileal and colonic arteriovenous malformations that were treated and grade 1 esophageal varices (Figure 3).
In the distal esophagus, there were 2 columns of grade 2 esophageal varices
(A), one of which had a purple blush to it, suggestive of high-risk
stigmata. The varices were banded (B). Colonoscopy showed early rectal
varices (C).
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Repeat upper and lower endoscopy revealed grade 2 distal esophageal varices that were banded, portal hypertensive gastropathy, and rectal varices, suspicious for worsening PH (Figure 4).
Home medication list.
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Medications were reviewed, and no new medications had been started or identified as hepatotoxic (Figure 5).
Liver biopsy with normal liver tissue, no evidence of congestive hepatopathy
or cirrhosis.
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Liver biopsy revealed normal liver tissue without evidence of congestive hepatopathy or cirrhosis (Figure 6).