Hepatic coma

Introduction Hepaticcoma is a central nervous system syndrome caused by metabolic disorders caused by severe liver function insufficiency. The main manifestations of consciousness disorder and coma. The liver is an important detoxification organ of the human body. All kinds of harmful substances produced by the metabolism of the human body must be detoxified by the liver, and life can be maintained. The primary diseases that cause hepatic coma are various types of cirrhosis, severe hepatitis (viral, toxic, drug), liver cancer and liver surgery, etc., with consciousness disorder and coma as the main manifestations. Clinically, it can be divided into two categories: acute and chronic hepatic coma.

Cause

Causes:

The causes are congenital weakness or acquired degeneration of the liver ligament, weakened abdominal muscle tension and decreased intra-abdominal pressure. Emphysema, massive pleural effusion on the right side and right subpulmonary effusion can also promote hepatic function in patients with hepatic ptosis, ascites, massive potassium diuresis, high protein diet, sleeping pills, infection and other factors. Further damage, liver detoxification is weakened, often induced hepatic coma. Increased blood ammonia is an important cause of hepatic coma in some patients. Ammonia is mainly from the intestines and is the product of protein decomposition by bacteria. In hepatic coma, excessive blood ammonia production and/or excessive metabolic clearance, as well as liver failure, the liver synthesizes blood ammonia into urea to eliminate blood ammonia, and causes blood ammonia to increase, and enters brain tissue to cause ammonia. Impaired, clinically coma.

an examination

Related inspection

MRI examination of liver, gallbladder, pancreas and spleen by liver, gallbladder and spleen

1, early performance

Sustained for several days to several weeks, should pay attention to early detection and early treatment. It usually appears after the above incentives.

(1) Changes in behavior, including whispering personality changes, often euphoric or indifferent, lack of clothing, casual notes, abnormal behavior.

(2) The confusion is confused and the statement is not normal. Including unclear words, confusion about the concept of time, people, and place, as well as hallucinations, fears, and irritations.

(3) Insomnia or sleepy morning wake up.

2, late performance

(1) Double upper limb flapping tremors (

(2) severe hepatitis, cirrhosis patients often accompanied by jaundice, ascites, spider mites, liver palm, skin bleeding points.

(3) The patient can smell a special smell when exhaling, like muddy and fruity, commonly known as "liver odor".

(4) Laboratory tests showed abnormal liver function and elevated blood ammonia.

Differential diagnosis

The hepatic sag should be differentiated from the liver. In the former, except for the lower edge of the liver beyond the rib arch, the upper boundary of the liver and the dullness of the liver also move down. Therefore, the area of the dullness of the liver does not expand, and the position of the liver is often taken after the deep supine position. Recoverable. Mild hepatic sag is not uncommon.

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