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Cardiac Cirrhosis May Present Ten Years after Pericardiectomy for Chronic Constrictive Pericarditis

Madhumita Premkumar, Devaraja Rangegowda, Amrish Sawhney, Awinash Sinha, Tanmay Vyas, Saloni Nitin Desai, Shrruti Grover, Joshi YK, Chhagan Bihari

A 51 year old male, presented to us with progressive abdominal distention and jaundice since 1 month, and a single episode of hematemesis. He had undergone pericardiectomy 10 years back for chronic constrictive pericarditis (CCP) and had completed a course of anti-tubercular therapy following the surgery. Physical examination revealed normal vital signs and mild icterus, moderate ascites, splenomegaly, and mild ankle edema. On endoscopy, he found to have large esophageal varices and endoscopic variceal ligation (EVL) was performed. Thyroid function tests, hepatitis serologies, autoimmune assays (ANA, AMA) ASMA, ferritin, ceruloplasmin, and α1-AT, level were unremarkable. Liver biopsy showed cirrhosis. After extensive evaluation, a diagnosis of cardiac cirrhosis was made.