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Volume 19, Number 7—July 2013

Letter

Possible Cause of Liver Failure in Patient with Dengue Shock Syndrome

Apichai Khongphatthanayothin, Atchara Mahayosnond, and Yong PoovorawanComments to Author 
Author affiliations: Bangkok Hospital Medical Center, Bangkok, Thailand (A. Khongphatthanayothin); Chulalongkorn University, Bangkok (A. Khongphatthanayothin, A. Mahayosnond, Y Poovorawan)

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Figure

Ultrasonograph with color flow Doppler image of the liver of a 10-year-old boy with liver failure associated with dengue virus infection. A) Day 2 of hospitalization, showing reversed direction of blood flow in the right branch of the portal vein (hepatofugal flow). There was diffuse increased liver parenchymal echo, swelling of the gallbladder wall, and right pleural effusion. B) Day 5 of hospitalization, showing returning normal direction of portal venous flow (hepatopetal flow). Liver parench

Figure. . Ultrasonograph with Doppler image of the liver of a 10-year-old boy with liver failure associated with dengue virus infection. A) Day 2 of hospitalization, showing reversed direction of blood flow in the right branch of the portal vein (hepatofugal flow). There was diffuse increased liver parenchymal echo, swelling of the gallbladder wall, and right pleural effusion. B) Day 5 of hospitalization, showing returning normal direction of portal venous flow (hepatopetal flow). Liver parenchymal echo changed to normal. Pleural fluid and swelling of the gallbladder wall also disappeared.

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