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Hepatic coma

What causes hepatic coma?

What causes hepatic coma?

Hepatic encephalopathy is caused when toxins that are normally cleared from the body by the liver accumulate in the blood, eventually traveling to the brain. Many of the symptoms of hepatic encephalopathy are reversible when promptly detected and treated.

Hepatic coma

Known hibernate hepatic (Hepatic encephalopathy – HE) or encephalopathy Babi Systemic (PSE – portosystemic encephalopathy) with several other names, such as: hepatic encephalopathy, coma and liver, and encephalopathy Babi-systemic and hepatic impairment.

What is hepatic coma?

Hepatic coma is a secondary health problem that may arise as a result of liver damage. The term hepatic coma is a medical term for a wide range of neuropsychiatric disorders that may appear in patients with liver disease. Hepatic coma may be a temporary or chronic condition.

Hepatic coma is caused by a defect in the liver, often caused by severe liver disease, and this defect may lead to a decreased ability of the liver to filter toxins from the blood. Over time, these toxins reach the brain, causing its cells to swell and disrupt the brain’s ability to perform its functions, which leads to the appearance of many symptoms on the patient.

Hepatic coma tends to develop slowly in the early stages, so some patients may not initially realize that they have this health problem, but as the condition deteriorates, severe symptoms may begin to appear on the patient, such as: fainting, and coma .

It is possible to try to treat this type of liver problem in the early stages by resorting to treatments that may help the body get rid of toxins in the bloodstream, but as the condition worsens, the patient’s body may become less responsive to treatments.

Types of hibernating liver  

There are three different types of hepatic coma:

1. Type A HE

It arises as a result of acute liver failure unrelated to liver disease. The main causes of hepatic coma of type A are as follows:

  • Take an overdose of acetaminophen.
  • Excessive drinking of alcohol.
  • Having certain health problems, such as: Wilson’s disease and hepatitis.

2. Type B HE

This type is not associated with liver disease, but may arise as a result of a specific shunt in the veins that causes blood to flow around the liver instead of directly to the liver, making the liver unable to filter toxins from the blood.

This type of defect may be congenital or may arise as a result of an accident.

3. Type C HE 

This type arises as a result of cirrhosis , a severe condition that may arise in the advanced stages of liver disease.

These are the most prominent liver diseases that may trigger cirrhosis: hepatitis B, hepatitis C, and non-alcoholic fatty liver disease.

Symptoms of hepatic coma

In the early stages, the patient may not have any symptoms, but as the condition progresses, the following symptoms may appear:

  • depression .
  • Fatigue.
  • anxiety.
  • stuttering in speech
  • Changes in personality, behavior, or mood.
  • Problems with memory and concentration.
  • Problems related to perception and thinking. 
  • confusion.
  • Disorders of balance or coordination.
  • Involuntary movements in some areas of the body, such as throbbing tremors (Asterixis). 
  • Loss of consciousness .
  • Myoclonus. 
  • Other symptoms, such as: sweet-smelling breath, excessive sleepiness, and seizures. 

Stages of hepatic coma

Hepatic coma is classified according to the severity of the symptoms shown in 5 stages, numbered from 0-4, the least severe of which is stage 0, and the most severe is stage 4, which may involve the patient losing consciousness or entering a coma. 

Causes of hepatic coma

Hepatic hibernation arises as a result of a defect in the liver that makes it unable to perform its usual functions through which it works to expel toxins from the body. These toxins begin to accumulate in the bloodstream to flow with the blood to the brain, causing an imbalance in it. ammonia;

These are the main factors that may increase the chances of developing hepatic coma:

  • Excessive drinking of alcohol.
  • Excessive protein intake by a person with liver damage.
  • Taking high doses of certain medications, such as: pain relievers and hypnotic drugs.
  • Gastrointestinal bleeding or constipation.
  • Having certain liver problems, such as: cirrhosis and hepatitis.
  • Having other health problems, such as: dehydration , electrolyte imbalance, failure of some body organs, and sepsis.

Diagnosis of hepatic coma 

There are no specific tests to diagnose this condition, but these procedures may help make a correct diagnosis:

  • Blood tests, to monitor for any infections or bleeding associated with liver disease.
  • Tests that may help rule out problems with symptoms similar to hepatic coma, such as: magnetic resonance imaging (MRI) and computed tomography (CT).
  • Physical examination of the patient.

Hepatic coma treatment 

The treatment that a doctor may recommend depends on several factors, such as: the severity of the coma, the type of symptoms present, the patient’s health status, and the severity of the damage to the liver causing coma.

These are some of the treatment solutions that the doctor may suggest:

  • The use of drugs aimed at achieving the following: treat infections, control bleeding , flush toxins from the body, reduce the levels of ammonia that is produced in the gut, and treat the disease that caused hepatic coma.
  • Discontinue use of medications that may have stimulated hepatic coma.
  • Undergo a liver transplant if the liver damage is severe.

source : wikipedia 

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