الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Patients with chronic viral hepatitis with or without cirrhosis exhibit several pulmonary complications which have a significant impact on morbidity and mortality. Awareness of the various thoracic lesions and their various CT chest manifestations in patients with chronic viral hepatitis can be helpful for making a differential diagnosis and planning proper management. The CT chest done for 30 Egyptian patients with chronic viral hepatitis (hepatitis C and B), Seven cases showed different CT signs of infection, two cases showed pneumonic patches, one case with cavitary lesions, one case with post primary T.B consolidation, three cases with empyema. Five cases known to have hepatitis C virus, cirrhosis and hepato-cellular carcinoma (HCC) were found to have thoracic metastases, Three cases showed prevascular and pretracheal mediastinal lymph nodes (lymph nodes metastasis). Five cases showed diffuse interstitial pulmonary fibrosis. Sixteen cases with ascites showed basal compression atelectasis. Thirteen cases associated with pleural effusion. Twenty cases showed evidence of pulmonary hypertension. On CT Chest they showed prominent main pulmonary artery (measurement was more than 30 mm). Eighteen of those patients had portal hypertension, suggesting the diagnosis of porto-pulmonary hypertension. One case had porto-systemic collaterals, CT showed esophageal thickening, luminal narrowing with nodular wall and dilated paraesophageal veins.Hydrothorax was found in 16 cases (53.3% of patients), 6.7% (n. =2) had loculated effusion. 15 cases (50% of patients) of hydrothorax were associated with cirrhosis and 12 cases (40% of patients) of hydrothorax were associated with ascites. Portal hypertension was found in 40% (n. =12) of the hydrothorax patients (P-value= 0.077). So hepatic hydrothorax is a relatively common complication of end-stage liver disease among cirrhotic patients. The mediastinal lesions were in the form of inflammatory, neoplastic lymph nodes or esophageal para-esophageal varices. Extrahepatic manifestations (EHM) chest syndromes could occur in any patient with chronic viral hepatitis especially in cases of liver cirrhosis, and it may represent the first manifestation of hepatitis infection, and frequently, EHMs are more serious than the hepatic disease itself.Despite the present study was a small study population, and is a single time point study assessing the CT pulmonary manifestations in patients with chronic viral hepatitis infection, our findings support that hepatitis viral infection is aetiologically involved in the development of several pulmonary abnormalities so multislice CT chest is mandatory for any patients with chronic viral hepatitis presenting with any chest complain.