Fatty liver (steatosis hepatis) is a term for excessively diffuse accumulation of neutral fats (triglycerides) inside liver cells causing the liver is usually slightly to moderately increased. The second term is liver steatosis.
Development of disease
Fatty liver occurs when fat accumulation in normal liver cells exceeds 5% of body weight. It can be temporary or long-term condition which in itself is not harmful, but indicates some disorder in the body. Left untreated, it can contribute to other diseases. If the cause can be detected and corrected the recovery.
The liver is the organ responsible for the processing of fats from food into forms that can be stored and used by the body. Triglycerides are a form of fat stored in the body and used for energy and the creation of new cells.Degradation of fat in the liver can be disrupted by a number of reasons leading to the accumulation of fat in liver cells. Fatty liver is usually not a painful condition that can be a long time unnoticed. In severe cases, liver and increase to three times and then it can be painful and sensitive. Nonalcoholic fatty liver is the accumulation of fat in the liver that is caused by alcohol, and is increasingly diagnosed in overweight women or diabetics.
Causes
The most common cause of fatty liver is alcoholism. Excessive alcohol consumption is changing the way decommissioning and storage of fat, and contributes to the chronic state of malnutrition is often present in alcoholics.
Other possible causes of fatty liver are:
thickness
diabetes
chemicals (eg carbon tetrachloride)
overdose of medication (corticosteroids, tetracycline, valproic acid, methotrexate, yellow phosphorus)
malnutrition
diet deficient in protein
pregnancy
Vitamin A poisoning
bypass surgery in the small intestine
cystic fibrosis
congenital metabolic disorders of glycogen, galactose, tyrosine and homocysteine
deficiency of the enzyme cholesterol esterase and arildehodrogenaze medium chain
Refsumova disease
abetalipoproteinemija
Reye's syndrome
Division
Fatty liver is the microscopic picture of liver cells can be divided into makrovezikularnu (large droplets of fat in the liver cell) and microvesicular (small fat globules). Makrovezikularna fatty liver is the most common and is caused by alcoholism, diabetes, obesity, corticosteroid therapy, prolonged infusion eating.
Symptoms
Symptoms of fatty liver associated with the degree, the onset and cause disease. Fatty liver is usually not associated with any symptoms, especially if it is a chronic condition.
If there are symptoms, they are: pain or tenderness under the right rib cage, abdominal swelling, jaundice and fever.Symptoms that occur less often in alcoholic fatty liver, and more frequently in fatty liver caused by pregnancy are: vomiting, nausea, loss of appetite and abdominal pain. The sudden, acute, caused fatty liver due to obesity can lead to significant painful stretching of the liver due to its capsule.
Makrovezikularna fatty liver is usually revealed during examination as insensitive, smooth, fully enlarged liver in alcoholics, obese and diabetic patients. There may be a pain in the upper right quadrant of the abdomen, jaundice and sensitivity, or may be only abnormality detected on casual examination of the abdomen or during autopsy.There is poor correlation between fatty liver and frequently used biochemical tests for liver disease. Alkaline phosphatase and transaminases may be mildly increased. Microvesicular fatty liver has a pronounced appearance characterized by fatigue, nausea and vomiting soon as the continuation of jaundice, hypoglycemia, and disseminated intravascular coagulation (formation of clots in the circulation).
Diagnosis
During a routine inspection or the designated physician may notice the increased and sometimes sensitive liver.Finding hard, painless and fully enlarged liver with minimal disruption of its function points to this disease.
If the patient has a chronic alcoholic, obese, underweight, pregnant or suffering from diabetes diagnosis is more likely. Laboratory blood tests (called liver tests) are used to determine the quality of liver function. Abnormalities were: increased AST and ALT levels, and in many cases, elevated alkaline phosphatase and the halt of bile.
Diagnostic imaging tests (ultrasound, magnetic resonance imaging, computed tomography) may be displayed typical changes in the liver. When the diagnosis is not sure can be done by percutaneous liver biopsy. The test is used alone can definitely diagnose fatty liver, involves taking a small piece of liver tissue is very thin needle through the skin, which is then analyzed microscopically, thus proving an increased amount of fat, and sometimes the primary disease. In pregnant women with fatty liver usually there are other disorders, eclampsia or preeclampsia.This situation is reflected elevated blood pressure, swelling and spasmodic attacks.
Treatment
Comes to healing treatment condition to cause fatty liver, and additional therapy.
Proper diet, abstinence from alcohol, drugs or harmful chemicals, the existing treatment of metabolic disorders, regular control of diabetes, weight reduction, treatment of digestive disorders, allowances of vitamins and minerals and so on. usually leads to recovery.
In alcoholic fatty liver gradual disappearance of fat from the liver performed after 5-8 weeks of proper diet and abstinence from alcohol. In pregnant women with fatty liver disease is recommended induction of labor if the pregnancy is high enough.
Forecast
Fatty liver is a condition that can be cured if detected in time and give medical advice and assistance. In some patients there is a tendency to develop other liver disorders, depending on the duration and severity of the condition. In fatty liver of pregnancy could endanger the life of the mother and child.
Severe liver damage may require her transplant. Alcoholic fatty liver may be accompanied by inflammation, dying of liver cells and liver.
Microvesicular fatty liver has a startling performance, and if the patient can survive the recovery. Nonalcoholic fatty liver generally has a good prognosis with rare exacerbations of the disease.
Prevention
Prevention of fatty liver may be proper, balanced diet, healthy lifestyle and abstinence from alcohol. In pregnant women needed quality and frequent checks to recognize this condition early and treated in time. To prevent Reye's syndrome, children should not be given drugs containing acetylsalicylic acid (Aspirin, Andol) for the treatment of influenza and other viral diseases.
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