Acute liver failure - causes and signs of acute liver failure

There is a classification of this disease in medicine. It includes the following types:

• Endogenous. It is formed by direct damage to the liver parenchyma
• Exogenous. It is formed by disorganization of blood circulation, which ultimately leads to the discharge of blood saturated with harmful components into the general hemodynamic circle.
• Mixed. With this type, both forms are manifested - endogenous and exogenous.

By functionality, three stages of liver failure are classified:

• Mild stage. It is asymptomatic. Moderate defects in functions are determined during diagnosis.
• Moderate stage. Accompanied by the appearance of symptoms: hepatomegaly, liver pain, colic, yellowness of the skin and mucous membranes.
• Severe stage. To all the above-mentioned signs are added those that characterize as encephalopathy and coma, arising as a result of a gross failure of organ functions.

Causes

The extreme degree of such a condition is formed during inflammatory processes that contribute to extensive dystrophic, fibrous or necrotic deviations. Deficiency may manifest itself as a consequence of severe types of hepatitis of various etiologies, cirrhosis, hepatosis, intoxication with hepatotropic toxic components, etc. The disease may also progress in the course of circulatory abnormalities caused by burns, blood poisoning, increased bleeding, etc.

Provoking factors of such deficiency are considered to be alcohol, medications with hepatotoxic action, anesthesia during surgical interventions, excessive amounts of protein in food, loose stools. In patients with a disorder of this organ, severe deficiency may manifest itself in infection, peritonitis, thrombophlebitis of the portal vein, etc.

Symptoms

This condition manifests itself as drowsiness, which alternates with excitement, adynamia, severe weakness. Nausea, loss of appetite, vomiting, and loose stools are typical. Edema, signs of hemorrhagic diathesis, jaundice, poisoning of the body with metabolic products, ascites, and fever appear.

In a pre-comatose state, neuropsychiatric disorders are observed: dizziness, slowness of speech and thinking, insomnia, hallucinations, tremors of the limbs.

Hemorrhages from the gums and nose may also occur. Pain in the hypochondrium, bad breath, and a decrease in the size of the liver indicate an approaching specific coma. Coma occurs in parallel with loss of consciousness, convulsions, hypothermia, abnormal heart rhythms, occurrence of certain reflexes, multiple organ failure.

Diagnostics

A general practitioner will help diagnose this disease after collecting complaints, anamnesis, conducting general clinical tests and studies. A consultation with a gastroenterologist, surgeon, infectious disease specialist, hepatologist or, in the case of extremely severe cases, a transplant surgeon may be required.

Laboratory features of the pathology are considered to be anemia, thrombocytopenia, hyperbilirubinemia, increased activity of serum transaminases. At the terminal stage, hypocholesterolemia, hypoalbuminemia, etc. are clearly expressed.

In the diagnosis of coma, as a terminal stage of insufficiency, EEG is performed, which determines the violation of the alpha rhythm, the dominance of theta and delta waves.

The basis for identifying this ailment is the clinical picture, taking into account the obtained data from the study of biochemical parameters, acid-base balance, electroencephalography.

Treatment

The main thing in the therapy of pathology will be infusion therapy, aimed at eliminating intoxication, improving blood circulation, metabolism, correcting electrolyte defects, restoring acid-base balance. Intravenous injections of glucose solutions, albumin, hemodez and other medications are used. Diuretics are prescribed to prevent swelling of the brain and lungs. A number of vitamins are recommended for a person: ascorbic acid, riboflavin, nicotinamide, and others.

In the presence of hemorrhagic syndrome, an injection of vicasol, aminocaproic acid, etc. solutions is administered; in case of coagulation disorders, transfusion of large volumes of plasma is used. Progression of the pathology requires taking glucocorticoid hormones and antibiotics. Also, for the purpose of detoxification, hepatologists prescribe hemodialysis, plasmapheresis, hemosorption, and lymphosorption.

Rapid intensive therapy significantly improves the prognosis for recovery. In deep coma, irreversible processes occur, leading to the death of the patient.

Prevention

To prevent the extreme degree of this ailment, it is necessary to observe:

• preventive measures for infectious and toxic organ damage;
• timely seek medical help for the treatment of diseases of the abdominal organs;
• balanced nutrition;
• refusal to drink alcohol and smoke.