medical complications of alcohol misuse
DESCRIPTION
MEDICAL COMPLICATIONS OF ALCOHOL MISUSE. CIRRHOSIS. Presented by Dr. Glynn Jones to Clinical Officers at Lewanika Hospital, Mongu, Zambia (Via Skype) Date: June 7, 2013. OVERVIEW CIRRHOSIS. Definition Clinical Manifestation Management of Cirrhosis & Complications. Definition - What is it?. - PowerPoint PPT PresentationTRANSCRIPT
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MEDICAL COMPLICATIONS OF ALCOHOL MISUSE
CIRRHOSIS
Presented by Dr. Glynn Jones to Clinical Officers at Lewanika Hospital, Mongu, Zambia (Via Skype)
Date: June 7, 2013
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OVERVIEW CIRRHOSIS
• Definition
• Clinical Manifestation
• Management of Cirrhosis & Complications
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Definition - What is it?
• Late stage of progressive hepatic fibrosis– It is irreversible in its advanced stages– It is potentially reversible in its early stages– Patients with cirrhosis are susceptible to a
variety of complications and their life expectancy is markedly reduced
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Clinical Manifestations
• Physical findings• A coincidental finding during surgery,
radiological or laboratory investigation• May present with decompensated cirrhosis• Esophageal varices with hemorrhage• Ascites• Spontaneous bacterial peritonitis• Hepatic encephalopathy
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Following slides demonstrate physical findings associated
with liver disease
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Spider Angiomata
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Dupuytren’s Contracture
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Gynecomastia (Male)
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Ascites
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Caput Medusae
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Diagnosis of Ascites and determination of cause
• 1500 cc of fluid collection in abdomen before being able to detect on physical exam
• Dullness to percussion in flank region
• Ultrasound is gold standard for diagnosis
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Diagnostic Paracentesis
• Left lower quadrant 14g angiocath• Cell count• Albumin• SAAG > 11g/l • 98% sensitivity for diagnosis of portal
hypertension• Cell count > 300 cells/ ml leukocytes indicative
of spontaneous bacterial peritonitis
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Treatment of Portal Hypertension
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• Tap fluid once to make diagnosis
• Low salt diet 2-4g / day
• Diuretics: – Lasix 40 mg– Aldactone 100 mg
• And titrate upwards to effect– Monitor weight– and renal function
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Hepatic Encephalopathy
• Triggered by alcohol and sepsis
• Treatment– Lactulose: orally or rectally
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Conclusion
• Alcoholic liver disease is common and preventable
• Complications can be managed and add quality of life to the patient