Massive hepatocyte necrosis

Introduction Large hepatocyte necrosis is common in acute hepatic necrosis. Acute hepatic necrosis refers to acute jaundice hepatitis caused by various causes. Mainly manifested as rapid jaundice within 10 days after onset, nausea, vomiting, liver shrinkage, and significant liver odor. One or more factors cause large hepatocyte necrosis in a short period of time, liver function is significantly reduced, serum alanine aminotransferase often decreases rapidly after a short-term increase, prothrombin time is prolonged, plasma albumin and total cholesterol are reduced , blood ammonia is elevated. Often skin and mucous membrane bleeding, ascites, lower extremity edema, proteinuria, etc., and irritability, paralysis, mania, depression and other neuropsychiatric symptoms, and then into a coma. A small number of patients have convulsions, deep reflexes, and pathological reflexes. If the treatment is not timely, the patient dies within a few days due to hepatorenal syndrome, liver failure or severe bleeding. Particularly severe cases can also die due to liver failure or severe bleeding before the onset of jaundice (7-10 days).

Cause

Acute hepatic necrosis, caused by a large number of hepatocyte injury and necrosis in a certain period of time by one or more factors, the integrity of the cell membrane of the hepatocytes is disrupted by the rupture of the plasma membrane, and finally leads to cell lysis, cell organelle death, cytoplasm The release of enzymes in the liquid should pay attention to daily exercise and sleep on time, and it is related to long-term drinking hepatitis cirrhosis, ascites, spleen and kidney.

an examination

Related inspection

Liver function test, liver disease, ultrasound diagnosis, hepatitis B, two and a half

Abnormal liver and kidney function, abnormal blood and urine, check the specific stomach and see if there is any abnormality. Ultrasound examination of hepatitis B two-and-a-half and liver diseases can be performed.

Differential diagnosis

Differential diagnosis of large hepatocyte necrosis:

1. Acute severe hepatitis:

(1) Necrotic type: characterized by large hepatocyte necrosis. The liver shrinks, the hepatocyte lysis disappears, and only a small amount of liver cells remain around the hepatic lobules. Generally, there is no hepatocyte regeneration and fibrous tissue hyperplasia, and residual liver cells and small bile ducts have cholestasis.

(2) edema type: prominent lesions for the liver cells widely show significant balloon-like changes, squeeze each other, forming a "plant cell"-like, there is still liver-like necrosis.

2. Subacute severe hepatitis: visible sub-bulk and large hepatic necrosis of different sizes, old and old, and hepatic cell nodular hyperplasia coexist, connective tissue hyperplasia in the portal area.

3. Chronic severe hepatitis: secondary to large or massive hepatic necrosis on the basis of chronic active hepatitis or post-hepatic cirrhosis. A number of hepatic lobules are involved, pseudo-lobules are formed, and the liver tissue structure is highly deformed.

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