Fetor hepaticus

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Dimethyl sulfide Dimethyl sulfide structure.svg
Dimethyl sulfide

Fetor hepaticus or foetor hepaticus (Latin, "liver stench") (see spelling differences), also known as breath of the dead or hepatic foetor, 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, or musty smell to it.[ citation needed ] [1]

The compound volatile dimethyl sulfide has been associated with it, [2] raising the possibility of an objective noninvasive measure of liver failure. [3] [4] A secondary form of trimethylaminuria is also associated with liver failure, and it has been suggested that trimethylamine is also a contributor to the odor of fetor hepaticus. [5]

See also

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References

  1. Van den Velde, S; Nevens, F; Van Hee, P; Van Steenberghe, D; Quirynen, M (November 2008). "GC-MS analysis of breath odor components in liver patients". Journal of Chromatography B. 875 (2): 344–8. doi:10.1016/j.jchromb.2008.08.031. PMID   18938115.
  2. 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. 875 (2): 344–8. doi:10.1016/j.jchromb.2008.08.031. PMID   18938115.
  3. Kaji, H; Hisamura, M; Saito, N; Murao, M (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.
  4. Tangerman, A; Meuwese-Arends, MT; Jansen, JB (Feb 19, 1994). "Cause and composition of foetor hepaticus". Lancet. 343 (8895): 483. doi:10.1016/s0140-6736(94)92729-4. PMID   7905979. S2CID   10538949.
  5. Mitchell, S; Ayesh, R; Barrett, T; Smith, R (May 1999). "Trimethylamine and foetor hepaticus". Scandinavian Journal of Gastroenterology. 34 (5): 524–8. doi:10.1080/003655299750026281. PMID   10423071.