Skip to main content

Anatomy and the Complications Associated with Liver Diseases!

 LIVER AND THE COMPLICATIONS ASSOCIATED WITH THE PROGRESSION OF DISEASE!


Liver:

  • The liver weighs up to 1.5kg in adults and is the 2nd largest organ in the body. Hepatocytes are the functioning unit of liver.
  • Impairment of liver may lead to:

  1. Acute liver diseases
  2. Chronic liver diseases
  3. Liver cirrhosis



Acute Liver Disease (ALD):

  • ALD is a self-limiting episode of hepatocyte damage which in most cases spontaneously without clinical sequelae, but acute liver failure (ALF) may develop. This is a rare condition in which there is a rapid deterioration in liver function with associated encephalopathy and coagulopathy.
  • ALF carries significant morbidity and mortality and may require emergency liver transplant.


Chronic Liver Disease (CLD):

  • CLD occurs when the longstanding cell damage causes permanent structural changes within the liver, with the loss of normal liver structure and functions.
  • In many cases, this may lead to cirrhosis where fibrosis sears divide the liver cells into areas of regenerative tissues called Nodules. It is usually irreversible but therapeutic interventions in Hepatitis B Virus (HBV)and Hepatitis C Virus (HCV), and hemochromatosis has demonstrated the ability to reverse cirrhosis.
  • CLD can progress to:

  1. Liver failure
  2. Portal hypertension
  3. Hepatocellular carcinoma


Causes of Liver Disease/ Etiology:

  1. Viral infections
  2. Hepatitis
  3. Alcohol
  4. Immune disease
  5. Vascular abnormalities
  6. Genetic and metabolic disorders


Clinical Features of Acute Infection:

Non-specific features include;

  1. Headache
  2. Nausea
  3. Development of jaundice within 2 weeks
  4. Vomiting
  5. Diarrhea
  6. Dark urine
  7. Pale stools
  8. Myalgia
  9. Arthralgia
  10. Anorexia
  11. Abdominal discomfort

Physical signs include;

  1. Liver tenderness
  2. Mild splenomegaly

  • Symptoms last longer than 3-6 weeks


Complications:

  1. Acute Liver failure (ALF)
  2. Chronic liver disease (CLD)
  3. Liver cirrhosis (HBV &HCV)
  4. Cholestatic hepatitis (HAV)
  5. Aplastic anemia


Investigations:

  1. Liver Function Test: Low serum transaminase, Plasma bilirubin exceeds twice of normal.
  2. Serological test: Confirms the cause of infection.


General Management:

  • Most patients do not need hospital care.
  • Drugs metabolized in liver (sedatives, narcotics) should be stopped.
  • Avoid alcohol consumption.
  • No specific dietary modification required.
  • Increase fluid intake.


Labels:

Comments

Post a Comment

Popular posts from this blog

Procedure of IV selection!

 IV DRUG THERAPY- SELECTION OF EQUIPMENTS AND INSERTION OF CATHETER Equipment: Canula selection: Select cannula based on purpose and duration of use and age of patient. Consider risk of infection and extravasation. Cannula made from polyurethanes are associated with decreased risk of phlebitis. Steel needles have higher risk of extravasation and should be avoided where tissue necrosis is likely if extravasation occurs.       2. Skin Prep: Antiseptic solution, use an aqueous based alternative if there is a known allergy to alcohol.       3. Other Equipment: Intravenous solution as ordered, torniquet, giving set, IV stand/pole, infusion pump, transparent occlusive dressing, tape or similar to secure cannula, gloves, paper bag.       4. Additional Equipment which may be required: Syring (5mL), sterile sodium chloride 0.9%, local anesthetics (in children), 3-way tap or triflow, short extension tube. Selection Of the Catheter Site: Generally ...
Post a Comment
Read more

General Mechanism of Actions of INSULIN.

GENERAL MECHANISM OF ACTION OF INSULIN AND RELATE HORMONES The body's main fuel is Glucose. Glucose is stored in the liver and muscles as Glycogen.  Excess glucose is stored in the adipose tissues which yield fatty acids via lipolysis. In the fasting state, free fatty acids supply much of the energy needs of the body except for the CNS which requires Glucose to function normally. Proteins can also be converted to glucose via gluconeogenesis. RELEASE OF INSULIN AND GLUCAGON Insulin and Glucagon are produced in the pancreas by the Islets of Langerhans . Beta cells   make up 70%-90% of the Islets and produce Insulin and Amylin while the a-cells   produce glucagon. The main function of insulin is to decrease blood glucose levels. Glucagon, along with other counter-regulatory hormones such as growth factor, cortisol, and Epinephrine, increases Blood glucose levels.  The opposing actions of Glucagon and Insulin along with other counter-regulatory hormones maintain a norma...
Post a Comment
Read more

Diabetes Mellitus: Clinical Presentation and Diagnosis!

 CLINICAL PRESENTATION AND DIAGNOSIS OF DM 2. SCREENING American Diabetes Association (ADA) recommends routine screening for T2 DM every 3 years in all adults starting at 45 years of age. Testing of T2 DM should be considered in any adult, regardless of their age, who have a BMI greater than or equal to 25kg/m2. The ADA does not currently recommend widespread screening for T1 DM because of the relatively low incidence in the general population, although measurement of Islet antibodies may be appropriate for high-risk individuals. 3.GESTATIONAL DIABETES: "Gestational diabetes is the glucose intolerance in women during pregnancy". All pregnant women who have risk factors for T2 DM should be screened for undiagnosed T2 DM at their first prenatal visit using standard diagnostic criteria.  Any women found to have diabetes in the early point at pregnancy is considered to have T2 DM or GDM. All other pregnant women, not currently known to have DM should be screened for GDM with a 75...
Post a Comment
Read more