Parenchymatous hepatitis

Description:

The inflammation of a hepatic parenchyma which is usually followed by an inflammation of interstitial fabric, and is frequent also dystrophic changes.

Symptoms of Parenchymatous hepatitis:

At hepatitis with preferential defeat of a parenchyma patients generally complain of moderate pains in right hypochondrium, a skin itch, a loss of appetite, the general weakness, abdominal distention, disturbance of activity of intestines.
The sizes of a liver and extent of its increase define as follows. In the beginning establish to Perkutorno (by means of percussion) the upper bound of a liver which normal corresponds to the lower bound of the right lung and passes across the right sredneklyuchichny line at the level of VI edge; the lower bound of a liver corresponds to the right costal arch. The liver size normal on the sredneklyuchichny line averages 10 cm. Determine by percussion also the liver sizes on median (7 cm) and the srednepodmyshechny line (about 12 cm).
The sizes of a liver can be determined also by palpation (palpation). At a palpation of a liver of the patient lies on spin, polusognuta legs in knees, muscles of a stomach are whenever possible relaxed. Inspecting the ends of fingers of the right hand during an exhalation when muscles of a stomach relax, feels bottom edge of a liver and determines density of hepatic fabric, liver size, existence of these or those deformations (tuberosity).
With bigger reliability the sizes of a liver define at ultrasonography.
At parenchymatous hepatitis the liver and a spleen are increased, moderate yellowness of integuments, mucous membranes and scleras is observed that it is connected with an abnormal liver function (parenchymatous jaundice).
Disturbance of functions of a liver is shown also in bleeding (disturbance of protrombinoobrazovatelny function), in decrease in protein content and cholesterol in blood (a hypoproteinemia, a hypochilesterinemia).

Reasons of Parenchymatous hepatitis:

Is caused by the most part an infection, we hide damage of a liver can be its main manifestation — so-called primary infectious hepatitises (an infectious disease, Vasilyev-Veyl's disease, yellow fever of the tropical countries), or represents only a complication of the main infection (secondary infectious hepatitises at a lung fever, a typhinia, sepsis, syphilis, a paratyphoid). Also toxic hepatitises which are caused by poisons (medicinal — at overdose, industrial, food) what are known: chloroform, Novarsenolum, quinophan, arsenic, fern extract, tetrachloride carbon, sulfanamide drugs, dinitrophenol, trinitrotoluene, heliotrope, mushroom poison (fly agarics, morels); in rare instances this disease is noted at toxicoses of pregnant women.

Treatment of Parenchymatous hepatitis:

At acute parenchymatous hepatitises carry out treatment according to an infection. At the toxic hepatitises caused by various poisons (food, industrial, medicinal), it is necessary to protect the patient from further intake of poisons, to provide neutralization and their removal from an organism with various methods and means. Generally treatment has to be directed to the maximum shchazheniye of a liver, reduction of poisoning of hepatic cells and increase in their ability to regeneration. Hospitalization (bed rest), moderate heat on area of a liver (the warming compresses) and dithis with plentiful supply of easily acquired carbohydrates, sufficient administration of full-fledged proteins, liquid and vitamins, especially vitamins C, In and To, and with restriction of fats is for this purpose necessary. Food has to be mixed, but preferential carbohydrate. Sick appoint fruit, berries, vegetables and their juice, sugar, honey, jam, white loaf, porridges. In hard cases enter into a vein to 100 ml 40% of glucose; it is reasonable to appoint in the form of drink or drop enemas 5% glucose solution to 1 — 2 l a day. For the best digestion of carbohydrates and increase in a glikogenization of a liver appoint small doses of insulin (on 5 PIECES 2 times a day) together with glucose. Proteins are necessary for creation (regeneration) of hepatic fabric. But purpose of proteinaceous food, especially animal protein, it is necessary to individualize. Proteins should be entered preferential with milk and vegetable food: porridges, bread, mealy dishes (macaroni, vermicelli and so forth) and especially cottage cheese rich with methionine. Fats should be limited as the adiposity in hepatic cells counteracts adjournment of a glycogen and reduces function of a liver. The emulsified fats (butter, sour cream, cream) in a small amount — 20 — 30 g are better transferred to days in the acute period; fats are reasonable as containing necessary vitamin A. In hard cases it is appointed камподон intramusculary on 2 ml of 1 — 2 time a day; at the hemorrhagic phenomena and an anemization — plasma transfusion and whole blood; at excitement of a nervous system, a bad dream — drugs of bromine, a valerian, Chlorali hydras (it is better in enemas), luminal, etc., for simplification of an itch — heat baths, rubdown of a body of 1 — 2% solution of carbolic acid, novocaine intravenously (10 — 20 ml of 0,25% of solution); at simultaneous damage of a gall bladder and bilious channels — duodenal sounding, cholagogue means (see Cholecystitis. Cholelithiasis). For some time, depending on weight and duration of a disease, sometimes up to 2 — 3 months after an extract from hospital, it is necessary to observe restriction of an exercise stress and a diet (to avoid some heavy greasy food, canned food, snack, alcoholic beverages). After this recovery period patients become quite able-bodied.