In steatosis hepatis – colloquially called fatty liver – (synonyms: Fatty liver; Hepar adiposum; Steatosis; Steatosis hepatis; ICD-10 K76.0: Fatty liver [fatty degeneration], not elsewhere classified, including nonalcoholic fatty liver)) is a mild to moderate increase in size of the liver due to deposition of triglycerides (neutral fats) in the hepatocytes (liver cells). Fatty liver … Fatty Liver (Steatosis Hepatis)
Medical history (history of illness) represents an important component in the diagnosis of steatosis hepatis (fatty liver). Family history What is the general health status of your relatives? Are there any liver diseases in your family that are common? Social history What is your profession? Are you exposed to harmful working substances in your profession? … Fatty Liver (Steatosis Hepatis): Medical History
Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Abetalipoproteinemia (synonym: homozygous familial hypobetalipoproteinemia, ABL/HoFHBL) – genetic disorder with autosomal recessive inheritance; severe form of familial hypobetalipoproteinemia characterized by deficiency of apolipoprotein B48 and B100; defect in the formation of chylomicrons leading to fat digestion disorders in children, resulting in malabsorption (disorder of food absorption). Endocrine, nutritional … Fatty Liver (Steatosis Hepatis): Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by steatosis hepatis (fatty liver): Endocrine, nutritional, and metabolic diseases (E00-E90). Diabetes mellitus type 2 – 2 out of 3 diabetic patients have a fatty liver. Metabolic syndrome – clinical name for the symptom combination of obesity (overweight), hypertension (high blood … Fatty Liver (Steatosis Hepatis): Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin, mucous membranes, and sclerae (white part of the eye), with attention to skin and mucous membrane color and hydration status. Abdomen (abdomen) Shape of the abdomen? Skin color? … Fatty Liver (Steatosis Hepatis): Examination
Laboratory parameters of 1st order – obligatory laboratory tests. Small blood count (alcohol consumption: MCV ↑). Fasting glucose (fasting blood glucose, fasting plasma glucose; preprandial plasma glucose; venous). HbA1c (long-term blood glucose value) Ferritin (iron stores) [ferritin ↑, in 29-50% of cases]. Triglycerides Total cholesterol and LDL/HDL ratio Liver parameters – alanine aminotransferase (ALT, GPT), … Fatty Liver (Steatosis Hepatis): Test and Diagnosis
Therapeutic targets Reduction of insulin resistance (decreased or abolished action of the hormone insulin) with decreased cardiovascular end-organ damage. Prevention of progression (progression) to nonalcoholic steatohepatitis (NASH) and/or hepatocellular carcinoma (HCC). In proven NASH, to prevent progressive fibrosis with development of cirrhosis (irreversible (non-reversible) damage to the liver and marked remodeling of liver tissue) and … Fatty Liver (Steatosis Hepatis): Drug Therapy
Pancreatic insufficiency – colloquially called pancreatic weakness – (synonyms: pancreatic insufficiency; pancreatic function, inadequate; ICD-10 E16. 9: disorder of internal secretion of the pancreas, unspecified) refers to the inability of the pancreas to produce sufficient digestive enzymes (= exocrine pancreatic insufficiency, EPI) and, in later stages, hormones such as insulin (= endocrine pancreatic insufficiency). It … Pancreatic Insufficiency: Signs and Diagnosis
Medical history (history of illness) is an important component in the diagnosis of pancreatic insufficiency (pancreatic insufficiency). Family history Are there any diseases of the digestive system in your family that are common? Social history Is there any evidence of psychosocial stress or strain due to your family situation? Current medical history/systemic history (somatic and … Pancreatic Insufficiency: Medical History
Endocrine, nutritional, and metabolic diseases (E00-E90). Cystic fibrosis (ZF) – genetic disorder with autosomal recessive inheritance characterized by the production of secretions in various organs that need to be tamed. Liver, gallbladder and bile ducts – pancreas (pancreas) (K70-K77; K80-K87). Chronic pancreatitis – chronic inflammation of the pancreas. Neoplasms – tumor diseases (C00-D48) Pancreatic carcinoma … Pancreatic Insufficiency: Or something else? Differential Diagnosis
To prevent hepatic encephalopathy (HE), attention must be paid to reducing individual risk factors. Behavioral risk factors Diet High protein (protein-rich) diet Consumption of stimulants Alcohol (woman: > 40 g/day; man: > 60 g/day). Drug use Ecstasy (also XTC and others) – collective name for a variety of phenylethylamines. Cocaine Drugs Laxatives (laxatives) Sedatives (tranquilizers)
The following symptoms and complaints may indicate hepatic encephalopathy (HE): Persistent fatigue Apathy (lack of passion) Limited performance Insomnia (sleep disturbances) Concentration disorders Rapid fatigability Sleepiness Mood swings Tremor (trembling of the hands) – “flapping tremor”. Change in writing – Even in the early stages, stage 0 (see under “Classification”), the writing becomes “spidery”. Decreased … Hepatic Encephalopathy: Symptoms, Complaints, Signs
