Senin, 19 September 2011

Diagnosis and Treatment for Liver Disease

Diagnosis and Treatment for Liver Disease

Basic abnormality : fibrosis and necrosis of hepatocytes throughout the liver, resulting in liver cell dysfunction, "portosystemic shunting" and portal hypertension

DIAGNOSIS

Main complaint
  • At first did not seem then occurs slowly
  • Often a sense of bloating
  • Tiredness, weakness
  • Weight dropped
  • Impotence, decreased libido
  • If further haematemesis, melaena
  • amenorrhea

Major signs
  • Face color / gray leather
  • Spider nevi
  • palmar erythema
  • Lunula dilated (white and red nail borders wide)
  • Flapping tremor (asterixis)
  • Lekonikia
  • Widening the veins of the chest and abdomen (caputmeducae)
  • Ginekomasti, tenderness
  • jaundice
  • Hepatomegaly, hardened
  • splenomegaly
  • ascites
  • testicular atrophy

Laboratory tests
  • SGPT, phosphate, alkaline, bilirubin increased
  • albumin decreased
  • Gamma globulin increases

Special inspection
  • liver biopsy
  • endoscopic variceal
  • "Cobblestone appereance" on the photo esophagus

COMPLICATIONS

  • Hematemesis, melena
  • hepatoma
  • hepatic coma
  • infection
  • hepatorenal syndrome


TREATMENT

  • Rest
  • Diet
  • Enough calories and protein
  • Alcohol avoided
  • Enough vitamin
  • When prekoma / comma avoided protein
  • Medical


PROGNOSIS
Depending on the extent of liver damage.

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