Excessive accumulation of fat in liver cells
Introduction
Introduction Excessive accumulation of fat in hepatocytes refers to lesions in which hepatic cells are excessively accumulated due to various causes. Fatty liver disease is a serious threat to the health of Chinese people and has become the second largest liver disease after viral hepatitis. It has been recognized as a common cause of occult cirrhosis. Fatty liver is a common clinical phenomenon, not an independent disease. Its clinical manifestations are asymptomatic, and the severe cases are fierce. In general, fatty liver is a reversible disease, which can be restored to normal after early diagnosis and timely treatment. Normal human liver total fat, about 5% of liver weight, contains phospholipids, triglycerides, fatty acids, cholesterol and cholesterol.
Cause
Cause
First, the causes of large fat-fat fatty liver are:
1 Nutritional: Childic malignant malnutrition (forashiorkor) gastrointestinal disease, pancreatic disease, obesity, intestinal bypass and long-term parenteral nutrition.
2 Metabolic: Diabetes, galactosemia, glycogenosis, fructose intolerance, Wilson's disease, tyrosinemia, hyperlipidemia, no beta lipoproteinemia, Wolman's disease, lipid Membrane and so on.
3 drug properties: including ethanol poisoning, long-term use of adrenocortical hormone or hepatotoxins.
4 virus infectivity: including hepatitis C and E viral hepatitis and other systemic viral infectious diseases.
5 occultity: Among the above causes, diabetes, obesity and alcoholic fatty liver are the most common. About 60%-90% of liver biopsy pathology in diabetic and obese patients can be found in different degrees of fatty liver.
Second, the causes of small fat-drop fatty liver are:
Acute pregnancy fatty liver, Reye syndrome, tetracycline fatty liver, Jamaican vomiting, valvalic acid (val-proate) poisoning, congenital urea cycle enzyme deficiency, ethanol poisoning and cholesterol lipid deposition disease, especially gestational fatty liver Tetracycline fatty liver and Reye syndrome are the most common.
Third, the formation of fatty liver often has the following types of reasons:
1. Alcohol is the culprit, long-term drinking, leading to alcoholism, resulting in reduced fat oxidation in the liver, nearly 60% of chronic alcoholics have fatty liver, 20% to 30% will eventually develop into cirrhosis.
2. Long-term intake of high-fat diet or long-term consumption of carbohydrates such as sugar and starch, so that liver fat synthesis is excessive.
Examine
an examination
Related inspection
Liver, gallbladder, pancreas and spleen MRI examination of liver, gallbladder, spleen CT examination
1. The clinical manifestations of fatty liver are diverse. Mild fatty liver has no clinical symptoms and is easily overlooked. According to records, about 25% of patients with fatty liver can be clinically asymptomatic. Some have only a feeling of fatigue, and most patients with fatty liver are fatter, so it is more difficult to find mild symptoms. Therefore, patients with fatty liver are more likely to be found by chance than during physical examination.
2, mild hepatic swelling can be tender, slightly tough texture, blunt edge, smooth surface, a small number of patients may have splenomegaly and liver palm.
3, moderate to severe fatty liver has a similar performance of chronic hepatitis, may have loss of appetite, fatigue, nausea, vomiting, weight loss, liver area or right upper abdomen pain.
4. When there is too much fat deposition in the liver, the liver capsule can be inflated and the liver ligament can be pulled, causing severe pain or tenderness in the right upper quadrant, fever, leukocytosis, and misdiagnosis as acute abdomen for laparotomy.
Diagnosis
Differential diagnosis
Identification:
Fatty liver can generally be divided into acute and chronic. Acute fatty liver is similar to acute and subacute viral hepatitis. It is rare. The clinical symptoms are fatigue, nausea, vomiting and varying degrees of jaundice. Hepatic coma and renal failure can occur in a short period of time. In severe cases, it can die in a few hours. Complications, if treated promptly, the condition can quickly improve in the short term.
