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Pathology
Alcohol excess can cause inflammation resulting in fat being deposited in the liver
Steatosis ➜ steatohepatitis ➜ fibrosis ➜ cirrhosis
Aetiology
Excess Alcohol Consumption
Signs
Spider naevi, ascites, peripheral oedema, jaundice, asterixis, caput medusae, splenomegaly, Dupuytren’s contracture
Symptoms
Ascites
Investigations
Bloods: FBC shows a macrocytic anaemia and LFTs show AST:ALT ratio >2
Imaging: Ultrasound Abdomen may show fatty liver and hepatomegaly
Liver Biopsy: Steatosis and Steatohepatitis
Treatment
Conservative: Cessation of alcohol
Medical: Glasgow Alcoholic Hepatitis Score ≥9 may benefit from steroids.
Maddrey’s Discriminant Function Score assess bilirubin and PT with a
score ≥32 indicating a possible benefit from steroids.
Prognosis
Maddrey Score ≥32 has a poor prognosis
Liver Cirrhosis
Key Facts
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Key Images
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Key References
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