When a gradual death of hepatocytes due to the completion of blood supply occurs under the influence of harmful external and internal factors, in this case liver necrosis is formed. The disease, as a rule, is expressed by pain in the right hypochondrium, nausea, vomiting, fever, and average liver growth. To establish a diagnosis of "liver necrosis", experts recommend that tests be performed immediately, since the correct treatment outcome will depend on the correctness of treatment.
What is liver necrosis
This form of the disease is formed against a background of impaired blood flow to the tissues of the organ as a result of mechanical, chemical or thermal effects. Death, as a rule, happens locally and has distinct edges. As a result of injury, the tissues begin to fester with gradual rejection, or they melt with the formation of a fairly dense scar.
Liver necrosis has two main forms of flow:
- The disease is accompanied by irreversible processes provoked by the direct death of the parenchyma.
- Liver necrosis is accompanied by rapid necrosis of the tissues of the organ.
According to experts, this ailment is characterized by rather rapid progression. If you do not treat the disease in a timely manner, then in a short period of time there is a decrease in the liver and necrosis of a significant part of it. Due to this progression, the patient may fall into the hepatic coma, which in most cases leads to death.
Existing species
Liver necrosis is usually classified relative to tissue necrosis sites. Therefore, the following types of ailment are distinguished:
- Necrosis of local lesion. This type of ailment is characterized by lesions of individual parts of the organ.
- Focal necrosis of the liver. This disease develops directly at the cellular level.
- Multiple necrosis. The development of this type of disease is characterized by damage to hepatocytes in different areas of the body.
- Bridge-like. This type is characterized by merging into a single whole of all injured areas of the organ, thereby forming necrotic stripes.
Massive necrosis and hepatic coma
Massive necrosis of the liver should be emphasized separately, since it is incurable and quite often leads to the death of the patient. As a rule, this type of ailment is formed against the background of hepatitis or intoxication of the body with poisons. According to experts, massive necrosis has an exceptionally acute course, while rather large lesions are formed.
With massive necrosis of the liver, the patient has pronounced jaundice, fever, nervous breakdowns. There are several variations of the onset of this condition: spontaneously and through the renal coma. As a rule, doctors distinguish 3 variations of coma:
- Spontaneous. In a patient, the liver stops fulfilling its purpose, as a result of which toxins enter other organs, and the brain is no exception. As a result of this, the main symptom is a disorder of the nervous system.
- Exogenous. This condition is characterized by a partial violation of the functionality of the organ, in the body, as a rule, the accumulation of ammonia occurs, which leads to severe intoxication.
- Hypokalemia. With this form of ailment, the functioning of the organ is partially completed. It should also be noted that the balance of electrolytes is significantly disturbed, which provokes dehydration of the body, and, as a result, depletion occurs.
Forms of ailment
Regarding the course of the disease, the disease has various forms. The most common are:
- Coagulation. A feature of this form of the disease is, first of all, the destruction of hepatocytes enriched with protein. The cause of cell injury is the precipitation of calcium ions in them, as well as a significant increase in the enzyme activity of the organ. Specialists distinguish subspecies of this form of the disease: partial and complete. Partial is characterized by the fact that there is a systematic modification of the membranes of the cells of the organ. Complete, in turn, is characterized by a holistic injury to hepatocytes. Relative to external signs, the destroyed cells turn into uneven foci with crescent-shaped nuclei. As a rule, infections are the provocateurs of the disease.
- Collivational. This form of the disease is characterized by an abnormal modification of hepatocytes with a low protein content. What is characteristic, the cell structure is empty without a nucleus. Specialists note that necrotic cells are characterized by significant dimensions with clearly defined boundaries. As a rule, they are localized remotely from sources of blood supply to the organ. In the last period of formation, focal collimation necrosis may develop. Regarding the strength of manifestation and the characteristics of the location in the hepatic lobule , the following subspecies of necrosis can be distinguished: focal, zonal-centrolobular, submassive and massive.
- Stepped. This form of the disease is characterized by direct necrosis of hepatocytes located nearby the portal vein passages. A provocateur of the formation of ailments is a sharp deterioration in the course of hepatitis, cirrhosis.
- Fulminant liver necrosis is the most severe form of the disease. Specialists note a large-scale injury to hepatocytes, and the immediate foci reach significant dimensions. Fulminant liver necrosis is characterized by lightning death of a significant number of elements, which increases the risk of death.
- The bridge form is formed against the background of rallying of the dead areas of the organ parenchyma. This form is characterized by an acute course. Experts note that this form of the disease significantly increases the risk of untreated blood entering the internal organs.
Etiology of the disease
According to experts, there are many reasons that can provoke the formation of liver necrosis. Significant causes of liver necrosis are organ trauma. Shocks are attributed to external factors in the development of the disease. It is also possible to classify radiation damage to external bases. Experts note that the most common causes of ailments are viral infections. These diseases include hepatitis B, C, D. Most often, in patients with an ailment such as hepatitis B, acute liver necrosis is observed. With prolonged or systematic drinking, a patient develops hepatos, which subsequently flows into alcoholic cirrhosis of the liver, which, in turn, quickly degenerates into necrosis.
Also an essential basis for the development of the disease is intoxication of the body. Poisoning can occur as a result of prolonged consumption of alcohol at the time of drug treatment, taking drugs. Regarding expert reviews, liver necrosis can even provoke natural toxicosis in pregnant women in the second half of motherhood.
The basis for the formation of necrosis may be sepsis. Oncology is of considerable seriousness, since the liver takes on a significant shock during the treatment of this ailment. Doctors say that the liver can simply not cope with the tasks and step into the phase of decomposition.
There is also a risk of necrosis due to organ transplantation. Since it happens that the gland does not take root, the consequence of this is the process of rejection and decay. In such cases, saving the patient is quite difficult, because there is a lightning infection of the blood.
The reasons for the development of necrosis can be attributed to the banal, at first glance, metabolic disorder.
Symptoms
According to doctors, for quite a long time, necrosis of the liver has “silent” symptoms. Therefore, the first signs of expression are nonspecific.
Liver necrosis symptoms at the initial stage of formation contains:
- Nausea.
- Loss of appetite.
- Upset stool.
- Vomiting
- Weight loss.
- Jaundice.
In the fair sex, necrosis can manifest as a breakdown of menstruation, and in men, in turn, problems with potency are possible.
In the process of development of liver necrosis, the symptoms begin to express much brighter. The subsequent stages of the development of the disease are characterized by an increase in the abdominal region, swelling of the ankles.
At the first stage of the development of the disease, the following symptoms may appear:
- Weakness, lethargy.
- Refusal of food.
- A lingering feeling of nausea.
The specific manifestations of ailments can be attributed to:
- Unusual color of urine and feces.
- Phlebeurysm.
- Trembling hands.
When quite serious organ modifications occur in the body, in this case it is possible to distinguish the following symptoms:
- The increase in size of the abdomen. As a rule, the reason for this modification is the accumulated liquid.
- Cramping pain in the right hypochondrium.
- Passion for the dimensions of the liver and spleen.
- Apathy, hallucinations.
Diagnosis of liver necrosis
At the slightest suspicion of the formation of an ailment, the patient should consult with such specialists:
- Gastroenterologist.
- Surgeon.
- Resuscitator.
Since liver necrosis (symptoms and treatment can only be determined by a qualified specialist) is a dangerous disease, doctors do not recommend self-medication. Since, not knowing the diagnosis, it can only aggravate the course of the disease.
The key diagnostic procedures are:
- Ultrasound
- MRI, CT of an injured organ and biliary tract.
- Single photon emission CT.
With the help of this diagnosis, the immediate foci of injury to the parenchyma are determined. In order to obtain more accurate information about the direct course and nature of tissue injury, a puncture biopsy is usually used.
The treatment of liver necrosis - the main methods
No specialist without a diagnosis will not diagnose liver necrosis. Treatment, first of all, begins with the elimination of the cause of the formation of the disease. According to experts, viral hepatitis is a particularly common root cause of ailments. Therefore, the course of therapy includes antiviral medications. This series of funds is characterized by cumulative characteristics, therefore, their effectiveness can be noticed after some time.
It is mandatory to include hepatoprotectors in therapy, which are used to directly support or revive the functions of the organ with a slight injury. Also, experts insist that the patient renounce all addictions, otherwise the therapy will not bring a positive effect.
If the cause of the formation of the disease is intoxication of the body, in this case the measures include detoxification.
If liver necrosis (a photo of the disease is presented in the article) was provoked by cirrhosis, in this case, the key method of healing is to stop drinking alcohol, and hepatoprotectors will help maintain the body.
Intensive therapy
Direct treatment of patients with acute liver necrosis is performed in the intensive care unit.
Intensive therapy for liver necrosis is urgently aimed at eliminating, primarily, liver failure.
Principles:
- Treatment is aimed at eliminating the cause that triggered the onset of pathology.
- Doctrine should be started immediately.
- Mandatory hospitalization of the patient.
- Doctors are aimed at directly supporting the metabolism and the body as a whole.
- As evidenced by numerous expert reviews, if you eliminate the cause of the formation of liver failure in a 10-day period, while maintaining the patient’s life support, hepatocyte regeneration occurs, which enables the person, first of all, to survive.
Folk remedies
There are no methods of alternative medicine to cure this ailment. But as prophylactic means, the recipes of traditional medicine can be used. To improve the functionality of the liver, you can use rose hips, the color of calendula and immortelle. You can independently prepare a healing infusion of these herbs.
Diet for liver necrosis
With a diagnosis of liver necrosis, the patient should renounce alcohol consumption. The attending physician must necessarily develop and paint a balanced nutrition menu.
As a rule, with such an ailment, table No. 5 is used, which implies the complete exclusion of salt. The diet of the patient should be based on such products:
- Vegetables.
- Fruits.
- Porridge.
- Gray bread.
- Dietary meat.
It is also necessary to pay attention to cooking methods. It is better to boil food, bake or cook in a steam bath.
Sour milk can be included in the diet, but in small quantities. It is allowed to add fish to the diet menu, since it is the source of most trace elements.
But it should be remembered that the treatment of any disease will be most effective with timely detection and treatment. Therefore, with the onset of signs of an ailment, it is better to consult a specialist.