Chronic liver failure - causes, symptoms, diagnosis and treatment
Chronic liver failure - Gradually developing liver dysfunction associated with progressive chronic diseases of the parenchyma. Chronic liver failure manifested symptoms of the underlying disease, dyspepsia (anorexia, vomiting, diarrhea), fever, jaundice, encephalopathy. In the diagnosis of chronic liver disease are taken into account the data of biochemical analyzes, liver ultrasound, gepatostsintigrafii, liver biopsy, EEG. Treatment of chronic liver failure is aimed at detoxification, elimination of metabolic disorders and phenomena of multiple organ failure.
Chronic liver failure
Gastroenterology may be the outcome of many diseases hepatobiliary and digestive tract. The clinical course distinguish acute liver failure that develops in a short time from the moment of liver disease, and chronic liver failure, growing gradually. In all forms of liver failure occurs metabolic disorder, detoxification and other functions of the liver, which leads to disruption of the central nervous system, until the development of hepatic coma.
Chronic liver failure progresses over months or years, it is characterized by gradual and slow development of clinical manifestations.
alcoholic, viral or autoimmune hepatitis, cirrhosis, cancer, fatty liver, helminth infections, tuberculosis.
Chronic liver failure can occur in the background of gallstone disease, where there is overlap concrement common bile duct: in this case, there is an accumulation of bile in intrahepatic biliary tract, damage and destruction of the hepatocytes with the substitution of connective tissue and the development of secondary biliary cirrhosis. In some cases, the disease may be caused by congestive heart failure or portosystemic shunting operations. The rare causes of chronic liver disease include genetic metabolic disorders - galactosemia, etc. glycogenoses
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Thus, in patients with chronic liver failure there is always a long-lived and slow-paced gepatonekroz, the progression of which is constrained to a certain time compensatory mechanisms. The sharp increase in chronic liver disease may be triggered by infection, alcohol intake, physical exhaustion, intoxication, taking large doses of drugs (such as diuretics), a momentary removal of large amounts of fluid at ascites, gastrointestinal bleeding, and so on. D. Happens in these cases, sudden decompensation of chronic liver disease with the development of hepatic coma.
hepatic coma.
dyspeptic symptoms - nausea, vomiting, diarrhea, anorexia. Symptoms of digestive disorders are often associated with the consumption of fatty or fried foods, smoked meats. There may be a wave-like fever, jaundice, skin lesions (hemorrhage, weeping and dry eczema, liver palms). Peripheral edema and ascites in chronic liver failure appear quite early.
A feature of chronic liver failure flow is the presence of endocrine disorders: infertility, decreased libido, testicular atrophy, gynecomastia, alopecia, atrophy of the breasts and uterus.
Neuropsychiatric disorders in patients with chronic liver disease are transient in nature, and manifest depression, memory loss, alternation of sleepiness and insomnia, anxiety, periodic soporous states, stunned, loss of orientation, inappropriate behavior, aggression, irritability, and so on. N. For failure to provide timely medical care may develop hepatic coma.
blood sugar (hypoglycemia) and cholesterol signs anticoagulation according to coagulation and others. In the urine increased levels of bilirubin and urobilin, in connection with which it acquires a yellowish-brown color.
Ultrasound of the abdomen reveals hepatomegaly, to evaluate the state of the parenchyma and portal vessels, determine the cause of chronic liver failure. To clarify the degree of liver dysfunction applied gepatostsintigrafiya. The complex diagnosis of chronic liver failure using MRI liver MDCT of the abdomen.
Carrying electroencephalography expedient when the signs of hepatic encephalopathy. Deceleration rate and decrease in the amplitude of waves recorded can warn of impending hepatic coma.
Laparocentesis and liver biopsy with cytological and morphological study of the resulting material can determine the cause of chronic liver disease and to appoint pathogenetic treatment.
hemosorbtion, plasmapheresis, hemodialysis.
With the progression of chronic liver failure raises the issue of Liver Transplantation.
hepatic encephalopathy mortality rate is 80-90%.
Prevent the progression of chronic liver failure possibly by eliminating the impact on the body of provoking factors (excessive protein intake, uncontrolled medication, alcohol abuse and so forth.). Patients with chronic liver disease should be kept under the supervision of a gastroenterologist or hepatologist.