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A number of specific symptoms are typical for liver necrosis, and it is important to identify them as soon as possible in order to save a person’s life, and also, if possible, try to restore the structure and functions of the liver, at least partially.
What is liver necrosis
The term “liver necrosis” refers to the death of liver cells. But such a diagnosis is not written in the card – this is a process that occurs inside the liver in various diseases.
Liver necrosis is a severe complication in various pathologies, for example, infectious lesions (viral hepatitis), poisoning (including drugs and excess alcohol), severe injuries (hit on the liver, squeezing it), severe circulatory disorders. Liver necrosis is typically a rapidly developing severe condition in which not only the liver itself can fail, but also many other organs, including the kidneys, heart, and brain. In addition, the development of hepatic encephalopathy (brain damage) and coma is possible.
According to research, several variants of liver necrosis have been identified:
- hyperacute necrosis with the appearance of brain damage (encephalopathy) for a week, moreover, usually against the background of severe jaundice;
- acute necrosis – if damage to the brain and organs occurs in the period from 8 to 30 days from the onset of liver problems;
- subacute necrosis is the death of cells between 4 and 12 weeks of liver disease.
The liver is a very hardy organ. Such a pathology as necrosis is rare, on average up to 2 – 3 thousand cases per year. Acute necrosis usually occurs in young people under 25-30 years old, subacute often occurs at the age of 40-45 years.
Causes of liver necrosis in adults
Liver necrosis can be caused by a variety of factors. Most often it occurs against the background of various types of hepatitis (inflammation of the liver). The share of viral lesions (hepatitis B, C, E, delta) accounts for up to 75% of all hepatitis with necrosis. Approximately 1% of people with hepatitis B may develop necrosis, and if it is hepatitis B + delta, then acute necrosis is possible in 30-40% of patients.
The next most common cause is poisoning by drugs or toxins. Particularly dangerous are surrogate alcohol, an overdose of paracetamol (30-50 tablets or more), long-term use of antibiotics, drugs for tuberculosis, and hormones. AIDS drugs can damage the liver.
In some cases, liver necrosis occurs against the background of serious problems with the heart and blood vessels, if there is a violation of blood flow to the organ. Prolonged bleeding of the liver (ischemia) threatens the development of necrosis of its lobules, or damage to the entire liver tissue with the development of liver failure.
Part of the liver cells may die due to the action of radiation or extreme temperatures, severe abdominal trauma if the liver is affected.
Rarely, blood tumors lead to necrosis if cancer cells infiltrate the liver and lead to the death of its tissue, as well as some metabolic disorders (especially if it is fat metabolism).
Necrosis can be of different severity: from small areas to almost total damage to the entire organ.
Symptoms of liver necrosis in adults
In many ways, the symptoms will depend on how badly the liver is affected. The most typical appearance of signs of liver failure, which leads to the formation of encephalopathy and coma. Early manifestations may include:
- soreness under the right ribs – this occurs due to the activation of the immune system, inflammation, swelling of the liver and stretching of its membrane, pain can radiate to the shoulder, lower back or shoulder blade on the right side;
- enlarged liver in size;
- the appearance of icteric skin color;
- nausea with vomiting, malaise;
- weight loss.
Important! If, against the background of the progression of the condition, the pain disappears, this indicates that a significant amount of liver cells have died, and this is a poor prognosis for the patient.
Due to the fact that the liver cannot neutralize toxins, the brain suffers. Ammonia is especially dangerous for him, which leads to encephalopathy (poisoning of the brain with a violation of its work). For her, lethargy, drowsiness, trembling of the limbs, memory problems, disorientation in space and time, muscle tone disorders, spasms are typical. If cerebral edema develops, breathing may be disturbed, blood pressure and heart rate may drop.
Against the background of liver necrosis, the kidneys suffer, the excretion of salts from the body is disturbed, which increases the poisoning of the body.
The metabolism of proteins suffers, because of which the composition of the blood is disturbed. It contains proteins that help in clotting, protection against infection. If they are not enough, bleeding, severe infections occur.
Against the background of problems with the liver, ulcers form in the stomach and intestines, bleeding from them may open.
Treatment of liver necrosis in adults
If liver necrosis is suspected, the patient needs hospitalization in intensive care or the intensive care unit. He will be treated by a gastroenterologist, an intensive care specialist and a surgeon.
Diagnostics
First of all, all standard tests, blood for liver enzymes and ultrasound of the liver are needed. CT or MRI of the organ, as well as a biopsy of suspicious foci, can determine areas of necrosis. To assess the state of the body, urine tests, ultrasound of the kidneys, ECG and encephalogram are needed. If infections are suspected, blood is taken for PCR testing.
Modern treatments
It is possible to treat patients with liver necrosis only in a hospital where there is intensive care. It is important to combat the increasing insufficiency of liver function. In order to prevent bleeding, vitamin K is administered, the release of hydrochloric acid in the stomach is suppressed, if convulsions occur, drugs are used against them. In severe cases, the patient is transferred to intravenous nutrition.
Antibiotics may also be indicated to suppress pathogenic intestinal flora, the introduction of amino acid solutions, but in severe liver damage, emergency organ transplantation is necessary.
Prevention of liver necrosis in adults at home
The basis of prevention is the timely treatment of any pathologies that can lead to liver necrosis.
Popular questions and answers
We asked a number of questions about liver necrosis gastroenterologist Marat Zinnatullin.
What are the consequences of liver necrosis?
The main cause of necrosis are viral hepatitis, drug, toxic (alcohol, etc.), radiation and thermal effects, vascular and heart disease, severe liver injury.
Liver necrosis is manifested by pain in the right hypochondrium, nausea, vomiting, fever, liver enlargement. With the progression of the disease, signs of liver and heart failure appear.