Cholestatic hepatitis

Description:

This disease of a liver of diffusion character as a result of an inflammation along the small bilious courses, stagnation of bile in liver tissue.

Symptoms of Cholestatic hepatitis:

At cholestatic hepatitis more expressed persistent jaundice and a laboratory syndrome of a cholestasia is usually observed: in blood serum the maintenance of an alkaline phosphatase, cholesterol, bile acids, the connected bilirubin, copper is increased. Under skin, in corners of eyes there are yellow dense spots — xanthomas and ksantelazma.

Allocate low-active (inactive), benign, persistent hepatitis and the active, aggressive, progressing recurrent hepatitis.

The puncture biopsy of a liver and laparoscopy allow to distinguish more precisely these two forms of hepatitis, and also to carry out differential diagnosis with other diseases of a liver.

Scanning of a liver allows to determine its sizes; at hepatitises the reduced or uneven accumulation of radio isotope drug in liver tissue is sometimes noted, in some cases there is an increased its accumulation in a spleen.

Liver fibrosis unlike hepatitis usually is not followed by clinical symptoms and change of functional hepatic trials. The anamnesis (existence in the past of a disease which could cause liver fibrosis), long observation of the patient and a puncture biopsy of a liver (in necessary cases) allow to differentiate it from chronic persistent hepatitis.

At a fatty hepatosis a liver usually softer, than at chronic hepatitis, the spleen is not increased, in diagnosis the puncture biopsy of a liver has crucial importance.

Reasons of Cholestatic hepatitis:

Stagnation of bile – disturbance of outflow of bile from a liver serves as the reason of development of cholestatic hepatitis.

Treatment of Cholestatic hepatitis:

Patients with chronic persistent and aggressive hepatitis out of an aggravation have to keep to a diet with an exception of hot, spicy dishes, refractory animal fats, fried food. Cottage cheese (daily to 100-150 g), not acute grades of cheese, low-fat grades of fish in a boiled look is recommended (a cod, etc.). At toxic and toksiko-allergic hepatitises complete cessation of contact with the corresponding toxic substance is extremely important, at alcoholic hepatitises - alcohol intake, in necessary cases treatment for alcoholism is shown.

At an exacerbation of hepatitis hospitalization, a bed rest, more rigid sparing diet with enough proteins and vitamins is shown. Appoint glucose on 25-30 g in, vitamin therapy (especially B1, B2, B6, B12 vitamins, nicotinic, folic and ascorbic acid). For the purpose of improvement of anabolic processes apply anabolic steroid hormones (methandrostenolone inside on 15-20 mg/days with a gradual dose decline or retabolil on 20 - 50 mg of 1 times in 2 weeks in oil). In more acute cases, especially with signs of considerable activation of immunocompetent system, corticosteroid hormones (on 20-40 mg of Prednisolonum a day) and (or) immunodepressants also in small doses are shown in small doses, but it is long. Carry out treatment by extracts and hydrolyzates of a liver (Vitohepatum, Sireparum and others), but it is careful as at acute hepatitises introduction of hepatic hydrolyzates can strengthen autoallergichesky processes and promote a bigger exacerbation of hepatitis.

At chronic cholestatic hepatitis the main attention has to be directed to identification and elimination of the reason of a cholestasia, in this case it is possible to expect success from medical actions.

Prevention of chronic hepatitises comes down to prevention of infectious and serumal hepatitis, fight against alcoholism, exceptions of a possibility of production and household intoxications hepatotropic substances, and also to early detection and treatment of acute and subacute hepatitis.