Liver failure and hepatic coma


  • Liver failure and its classification
  • Hepatic coma

  • Liver failure and its classification

    Liver failure - a pathological condition characterized by disorders of various kinds of metabolism in the body and intoxication products of protein metabolism.

    There are several classifications of liver failure. According to one of these, hepatic failure divided into endogenous and exogenous.

    Endogenous hepatic failure developsas a result of degeneration or necrosis of liver cells, and observed, for example, acute and chronic hepatitis, gepatozah, cirrhosis and other liver diseases.

    Liver failure and hepatic comaAt the core of endogenous hepatic insufficiencyIt is a non-specific response of the liver cells to the action of damaging factors. The clinical picture is the following: loss of appetite, aversion to tobacco smokers, alcohol and food intolerance, nausea and weakness, reduced disability, emotional disorders, etc..

    With long-term chronic course markedearthy-gray skin color or yellowness, signs of vitamin metabolism disorders (poor vision in the dark, and others.), endocrine disorders (women - menstrual disorders, men - decreased sex drive, impotence, testicular atrophy, female type of hair distribution) skin lesions (e.g., vascular "sprockets"), hemorrhage or bleeding (e.g. gastrointestinal), edema, ascites, and others. Usually observed symptoms of underlying disease.

    By exogenous hepatic insufficiencyunderstand the process of toxic products of metabolism in the body and microbial toxins absorbed from the intestine and enters from the portal vein into the bloodstream, bypassing the liver (eg, thrombosis of the portal vein). The changes of liver cells can be minimized. Exogenous hepatic insufficiency manifested recurring mental health problems (emotional instability, irritability, insomnia at night and sleepiness during the day, the mind is disturbed in the future), and neurological symptoms. These disorders are transient in nature, they are usually completely or partially reversible.

    distinguished acute The clinical course andchronic liver failure. First observed mostly in acute hepatitis, subacute liver disease, and in some cases of poisoning. Chronic liver failure develops gradually in patients with chronic hepatitis, cirrhosis of the liver. It progresses slowly, reaching high severity as acute liver failure and can lead to hepatic coma.

    Hepatic coma

    Involvement of the central nervous systemhepatic coma due to mainly metabolic disorders. This important co-factors are violations of the acid-base balance and water-salt metabolism and others. As a result of these violations are oppressed processes of biological oxidation in the brain, the inhibition of the transfer of excitation in the synapses and depression of the central nervous system. In hepatic coma is usually observed a massive necrosis of liver parenchymal.

    Central to the clinical picture of hepatic coma occupy the mental and neurological disorders. Depending on their severity, there are three stages of coma:
    • Preko,
    • threatening anyone,
    • actual coma.

    is an important symptom precomaemotional disorders (euphoria or depression, apathy, etc.), slow thinking, sleep disorders (insomnia, sleepiness during the day and at night), the deterioration of orientation, sometimes the difficulty of speech, unmotivated behavior. Under threatening coma observed confusion, disorientation in time and space, there may be bouts of excitement, sometimes with delirium, alternating with depression and drowsiness. Characteristic flapping tremor of the fingers. In fact there is no consciousness of a coma, marked muscle tone disorders, and others. In the first two stages of coma, central nervous system is fully reversible, rational treatment leads to a rapid disappearance of her symptoms.

    If you suspect the presence of hepatic comathe patient should be hospitalized immediately. Therapeutic measures in hepatic coma include a balanced diet (with the exception of dietary protein income, etc..), Suppression of the formation and removal from the body of toxic substances, the recovery process of biological oxidation, acid-base balance and water and salt balance, and others. The forecast hepatic coma depends on its depths - in the early stages of treatment possible with vigorous recovery, coma stage proper in most cases the process is irreversible.

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