WEEK: LECTURE: DIGESTIVE ACCESSORY ORGAN DISEASES 4 LIVER FAILURE Acute COMPLICATIONS: 50% due to paracetamol overdose · Jaundice Chronic Fatty liver disease Alcoholic (Fatty) liver disease Non-alcoholic Fatty liver disease Hepatitis B and C Portal hypertension and ascites Hepatic encephalopathy Coagulation defects Hepatorenal syndrome (HRS) and renal Failure due to decrease GFR Loss OF 80 to 90% Function Seroncunt Hlad Blood Cell JAUNDICE CLASSIFICATION: Bilirubin metabolism and excretion are not balanced Yellowish pigmentation of the skin and eyes Due to high levels of bilirubin in the blood (hyperbilirubingemia) Can be classified by location: A Pre-hepatic 1 Btvordin B Hepatic C Post-hepatic Fico birubio Liver + Kidney Pre-hepatic jaundice Haemolytic anaemias Increased production of bilirubin Hepatocellular jaundice Hepatitis Cirrhosis Decreased hepatocellular uptake or excretion Impaired or Failure to conjugate bilirubin Post-hepatic obstructive jaundice Bile duct blockage Tumour Decreased hepatocellular excretion due to impaired or abnormal bile Flow PORTAL HYPERTENSION AND ASCITES Decreased blood Flow through liver due to scarring causes increase in Venus pressure in hepatic portal vein Hepatic encephalopathy Portal hypertension causes: Development of collateral blood vessels that bypassed the liver Can lead to hepatic encephalopathy Development of a oesophageal varices (dilated veins ) IF varices rupture can lead to haematemesis Acute, severe GI bleeding is a medical emergency Loss OF 20% blood volume in 24 hours can result in hypovolaemic shock Ascites 0 CIRRHOSIS Hepatic lymph Malnutrition Skin spider angiomata Esophageal varices 0 Splenomegaly Portal vein Splenic vein Periumbilical caput medusae Congestive splenomegaly Ascites Hemorrhoids Testicular atrophy