1 / 18

MEDICAL COMPLICATIONS OF ALCOHOL MISUSE

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?.

nadda
Download Presentation

MEDICAL COMPLICATIONS OF ALCOHOL MISUSE

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. 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

  2. OVERVIEW CIRRHOSIS • Definition • Clinical Manifestation • Management of Cirrhosis & Complications

  3. 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

  4. 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

  5. Following slides demonstrate physical findings associated with liver disease

  6. Spider Angiomata

  7. Palmar Erythema

  8. Nail Changes: [Muehrche’s Nails]

  9. Dupuytren’s Contracture

  10. Gynecomastia (Male)

  11. Ascites

  12. Caput Medusae

  13. 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

  14. 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

  15. Treatment of Portal Hypertension

  16. 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

  17. Hepatic Encephalopathy • Triggered by alcohol and sepsis • Treatment • Lactulose: orally or rectally

  18. Conclusion • Alcoholic liver disease is common and preventable • Complications can be managed and add quality of life to the patient

More Related