Hepatogenic edema

Introduction Liver qi stagnation syndrome refers to abnormal liver function due to liver dysfunction. Decompensated cirrhosis and edema are mainly manifested as ascites. It can also first occur in sacral edema, accompanied by liver palm, spider mites, liver pain, fatigue, and complexion. Dark and dark, loss of appetite, fullness after eating, nausea, vomiting, symptoms of portal hypertension.

Cause

There are many causes of cirrhosis, and the main causes are different in different regions. Syndrome of stagnation caused by suffocation and qi stagnation is common in patients with viral hepatitis, cirrhosis, liver cancer and so on.

Etiology and pathogenesis

1, due to portal hypertension, hypoalbuminemia, decreased colloid osmotic pressure, resulting in extravasation of blood components.

2, excessive lymph production: liver venous return blocked, increased secretion of antidiuretic hormone caused by increased water reabsorption.

3. Renal blood flow, sodium excretion and urine output are reduced.

an examination

Related inspection

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

The diagnosis of decompensated cirrhosis is not difficult, and the early diagnosis of cirrhosis is difficult.

Compensation period

The history and symptoms of chronic hepatitis are available for reference. If there are typical spider mites, liver palm should be highly suspected. The liver texture is hard or not smooth and (or) the spleen is >2cm, hard, and no other reason to explain, is the basis for the diagnosis of early cirrhosis. Liver function can be normal. Protein electrophoresis may be abnormal, monoamine oxidase, serum P-III-P elevation may help diagnosis. When necessary, the liver is subjected to pathological examination or laparoscopy to confirm the diagnosis.

Decompensation period

Symptoms, signs, and tests have significant manifestations, such as ascites and esophageal varices. Obvious splenomegaly with spleen hyperfunction and abnormal liver function tests, etc., is not difficult to diagnose. But sometimes it needs to be differentiated from other diseases.

Differential diagnosis

Identification:

(1) Cardiogenic edema

The clinical manifestation of cardiogenic edema is that edema first appears in the sagging part of the body, followed by systemic edema, accompanied by jugular vein engorgement, hepatomegaly, elevated venous pressure, chest and ascites. Cardiac edema can occur when clinical causes of pulmonary heart disease, hypertensive heart disease, and other causes of right heart failure.

(2) Nephrogenic edema

Nephrogenic edema starts from the face of the eyelid and extends to the whole body. The development is often rapid, and the edema is soft and the mobility is large. With other kidney disease symptoms: such as high blood pressure, proteinuria, hematuria, tubular urine, fundus changes. Mostly caused by acute glomerulonephritis, nephrotic syndrome, hypertension, diabetes and other diseases caused by secondary kidney disease.

(3) Hepatogenic edema

Decompensated cirrhosis and edema mainly manifested as ascites, but also the first edema of the ankle, accompanied by liver palm, spider mites, liver pain, fatigue, dark complexion, loss of appetite, fullness after eating, nausea, vomiting, Symptoms of portal hypertension.

(4) dystrophic edema

Edema often spreads from the foot to the whole body, with pale, weak, and blood plasma albumin levels are reduced. Found in chronic wasting diseases, chronic acid deficiency, protein-losing gastrointestinal diseases, severe burns and other hypoproteinemia, or vitamin B deficiency.

(5) drug edema

Can be seen in the course of taking prednisone, cortisone, birth control pills, insulin, Rauvol Wood, licorice preparation, indomethacin.

(6) Toxic edema in pregnancy

Often occurs after 24 weeks of gestation. More common in the first child, twins, polyhydramnios or high blood pressure, high maternal. Its characteristics are: edema is more serious, and is accompanied by high blood pressure and proteinuria.

(7) Mucinous edema

Mucinous edema is characterized by thin and bright edema, pressing without depression, edema on the face and lower limbs, severe body involvement, accompanied by weakness, chills, dry skin, hair loss, apathy, constipation, anemia, libido Decline, female menstrual disorders.

diagnosis:

The diagnosis of decompensated cirrhosis is not difficult, and the early diagnosis of cirrhosis is difficult.

1. Compensation period: The history and symptoms of chronic hepatitis are available for reference. If there are typical spider mites, liver palm should be highly suspected. The liver texture is hard or not smooth and (or) the spleen is >2cm, hard, and no other reason to explain, is the basis for the diagnosis of early cirrhosis. Liver function can be normal. Protein electrophoresis may be abnormal, monoamine oxidase, serum P-III-P elevation may help diagnosis. When necessary, the liver is subjected to pathological examination or laparoscopy to confirm the diagnosis.

2. Decompensation: Symptoms, signs, and tests all have significant manifestations, such as ascites and esophageal varices. Obvious splenomegaly with spleen hyperfunction and abnormal liver function tests, etc., is not difficult to diagnose. But sometimes it needs to be differentiated from other diseases.

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