Gastro - Insuficiencia Hepatica

7/26/2019 Gastro - Insuficiencia Hepatica

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Causes of cirrhosis.

Autoimmune hepatitis

Alcohol-induced liver injury

Drug- or toxin-induced liver injury (ie, methotrexate)

Viral hepatitis B, C, or D

Metabolic diseases!1-Antitrypsin deficiency

Wilson's disease

Hemochromatosis and other copper disorders

Tyrosinemia

Nonalcoholic steatohepatitis (NASH) or fatty liver

Vascular derangements

Chronic right heart failureBudd-Chiari syndrome

Long-standing portal vein thrombosis

Biliary disorders (bile ducts or gallbladder)

Primary biliary cirrhosis

Cystic fibrosis

Sarcoidosis

Biliary cirrhosis secondary to chronic large bile ductobstruction

Primary sclerosing cholangitis

Biliary atresia

Congenital paucity of intrahepatic ducts

Progressive familial intrahepatic cholestasis

Malnutrition and postjejunoileal bypass surgery

Cryptogenic diseaseFrom: Current Diagnosis & Treatment in Gastroenterology - 2nd Ed. (2003)

Common causes indeveloped countries

AlcoholismChronic Hepatitis C infection

Asia and AfricaChronic Hepatitis B infection

associated with diabetes, proteinmalnutrition, obesity, coronary artery

disease, and treatment with

corticosteroid medications


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HIGADO

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Due to !estradiolresulting from

impaired

estrogen

metabolism

From: Current Diagnosis& Treatment in

Gastroenterology - 2nd

Ed. (2003)

Symptoms &Complications

Accumulation

of fluid inperitoneal

cavity due to

hepatic

hypertention

Due to portalhypertension

Other non-specific

symptoms

weakness, fatigue,

anorexia, weight

loss

speckledmottling of

the palm

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venous system gets

shunted through here

Portal blood flowthrough vessels here,

likely to bleed

Due to "processingof bilirubin


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Encefalopata


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Encefalopata

Factores agravantes

Hemorragia gastrointestinal

Hipovolemia

Hipokalemia

Hipoglucemia Uremia

Infeccin

Constipacin

Sedantes y analgsicos

Alta ingesta de protenas


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Sndrome hepatorenal

Etiologa desconocida

Hay oliguria y anuria

Esencial corregir la hipovolemia

Dopamina, furosemida, manitol

Hemodilisis

Mal pronostico

Manejo de falla heptica


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Manejo de falla heptica

fulminante

Diagnostico de la causa

Manejo de complicaciones

Antibiticos

Vitamina K Lactulosa

Monitorear glucosa TP y TTP

Ventilacin mecnica

En caso de dao por paracetamol

N-acetil cisteina

Trasplante heptico

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Gastro - Insuficiencia Hepatica