10. Hepatic failure syndrome

This is a pathological condition accompanied by a violation of the basic functions of the liver

(absorption-excretory, metabolic and synthetic).

CAUSES:

1. acute diseases and lesions of the liver (acute hepatitis, leptospirosis, alcoholic, toxic and drug hepatitis.

2. chronic liver disease (chronic hepatitis and cirrhosis of the liver, hemochromatosis, Wilson-Konovalov’s disease, etc.)

3. malignant tumors of the liver.

1. small liver failure or hepatosuppressive syndrome (hepatodepression), in which various violations of the liver function develop, but without the development of encephalopathy.

2. large liver failure (hepatathy, hepatic encephalopathy, hepatocerebral syndrome) - severe liver failure, which is accompanied by hepatic encephalopathy with the subsequent development of coma.

Signs of hepatic encephalopathy:

1. Decreased intelligence, slowing thinking, excitability and euphoria, which are replaced by

depression, drowsiness, auditory and visual hallucinations, memory lapses.

2. Sometimes tonic cramps, twitching of various muscle groups, a symptom of "clapping tremor".

2. Tendon and pupillary reflexes are reduced, pathological neurological reflexes appear (Babinsky, Gordon, Rossolimo, etc.).

2. General weakness, lack of appetite, weight loss.

3. Hepatic breath.

4. Jaundice intensifies, the size of the liver decreases (especially in acute liver pathology).

5. The phenomena of hemorrhagic diathesis are growing.

6. Ascites, swelling.

7. The body temperature is increased (in the terminal stage - reduced).

8. Increased serum ammonia levels.

9. A hepatic coma develops.

Signs:

1. consciousness is completely lost, do not respond to light;

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2. Kussmaul breathing, subsequently - Cheyne-Stokes, Biota;

3. the stiff neck muscles and limb muscles;

4. pathological reflexes of Babinsky, Gordon, Zhukovsky, in some cases grasping and proboscis;

5. Blood pressure is reduced, tachycardia, deafness of heart sounds;

6. Jaundice is pronounced, the size of the liver is reduced;

7. Anuria;

2. Hemorrhagic syndrome is expressed (skin hemorrhages, nose, stomach, intestinal, uterine bleeding);

2. In the blood: leukocytosis, azotemia, bilirubinemia, lower potassium, cholesterol, lower previously increased activity of ALT, AST, LDH, cholinesterase;

2. Lowered body temperature;

3. ECG - hypersynchronous delta waves dominate.

12. Cytolysis syndrome (cytolytic syndrome)

Nonspecific reaction of liver cells to the action of damaging factors (destruction of liver cells). It is based on a change in the permeability of cell membranes and their organs. This leads to the release of the constituent parts of the cells into the intercellular space and into the blood - and the entry of sodium and water into the cell.

REASONS: acute and chronic hepatitis and cirrhosis of various origins, swollen and tumor metastases in the liver, shock of any nature, starvation. SYMPTOMS:

1. Biochemical parameters: increased activity of ALT, AST, aldolase, iron, bilirubin in blood serum, decreased blood coagulation factors, albumin, cholinesterase activity;

2. Signs of hepatic cell failure;

3. Asthenovegetative syndrome;

4. Dyspeptic syndrome;

5. Hepatic jaundice syndrome;

6. Syndrome of endocrine disorders: gynecomastia, decreased libido, testicular atrophy, impaired hair growth;

7. Skin disorders;

8. Neuropsychic manifestations;

9. Hemorrhagic diathesis.