Share your insights

Help us by sharing what content you've recieved in your exams


Alcoholic Hepatitis

Background Knowledge ๐Ÿง 

Definition

An acute inflammation of the liver caused by excessive alcohol intake. It’s characterised by liver dysfunction and hepatocellular necrosis.

Aetiology

  • Typically seen in individuals with a long history of high alcohol intake.
  • Amount and duration of alcohol intake, genetics, and diet can influence susceptibility.

Clinical Features ๐ŸŒก๏ธ

Clinical Features

  • Rapid onset jaundice.

  • Anorexia, nausea, and vomiting.

  • Abdominal pain (usually in the right upper quadrant).

  • Fever.

  • Hepatomegaly.

  • Ascites and signs of liver failure in severe cases.

Investigations ๐Ÿงช

Initial Tests

  • Blood tests: Raised bilirubin, raised transaminases (with AST typically greater than ALT, often in a 2:1 ratio), elevated gamma-glutamyltransferase (GGT), and leucocytosis.
  • Alcohol levels: Might be elevated.

Diagnostic Tests

  • Liver biopsy: Gold standard for diagnosis but not always necessary; shows hepatocyte ballooning, neutrophil infiltration, and Mallory bodies.

  • Imaging: Ultrasound or CT may show hepatomegaly and exclude other pathologies.

Management ๐Ÿฅผ

Management

  • Abstinence from alcohol: Primary intervention and is essential for improvement.

  • Corticosteroids: Used for severe alcoholic hepatitis, reduces inflammation; typically prednisolone.

  • Nutritional support: Many patients are malnourished.

  • Supportive care: Addressing complications like ascites, encephalopathy, and bleeding varices.

Prognosis

  • Maddrey’s discriminant function: A score to determine severity and prognosis.

  • Continued alcohol consumption has a poor prognosis.

  • Abstinence can lead to complete recovery or progression to cirrhosis in some cases.

Complications

  • Liver failure

  • Portal hypertension

  • Hepatic encephalopathy

  • Ascites

  • Variceal bleeding

No comments yet ๐Ÿ˜‰

Leave a Reply