Cirrosis Hepática secundaria a Alcoholismo Crónico

Abstract

The next case to be analyzed is a patient of 49 years old, male, mestizo, a partner, resident in the enclosure the Toquillal city of La Mana, dexterous, Catholic, complete primary, dealer, personal medical history Poliomyelitis from 4 years old, diabetes mellitus type 2 for 4 years using Metformin + glibenclamide 500/2.5 mg, Gastritis, with a family history of heart disease in paternal grandparents and type 2 diabetes mellitus in their parents, refuses surgical and allergic history. Habit 4 cigarettes a week for 29 years until now, and alcohol 1 to week until drunkenness. Patient evaluated by hematemesis, melena, disturbance of consciousness, ascites, esophageal varices and ligation of them.

Cirrhosis is the final stage of all progressive chronic liver disease. It is a diffuse process characterized by loss of hepatic parenchyma, formation of fibrous septa and regenerative nodules that cause distortion of the normal architecture and vascular anatomy. Approximately 40-60% of cases in Europe and North America are due to alcohol and nonalcoholic fatty liver disease, while 25-30% is the result of viral chronic hepatitis. Currently it is considered that cirrhosis is a dynamic and potentially reversible disease in early stages.

The causal link between excessive alcohol consumption and the development of liver injury is known for many centuries. Alcohol is considered today one of the most common causes of liver cirrhosis and liver transplant second in the world. longitudinal observational studies of people in different countries have shown that changes in drinking habits (US abstention after the so-called "Dry Law" or during the world wars in Europe) are associated with parallel changes in the Cirrhosis mortality.

Currently called "ALD" the spectrum caused liver damage by ethanol. alcoholic liver steatosis, alcoholic hepatitis and alcoholic liver cirrhosis: In this concept three developmental syndromes are included. It is three anatomoclinical entities that NAFLD represents the initial phase, while alcoholic hepatitis and alcoholic liver cirrhosis are more severe stages of the same disease. Today it is known that the alcoholic hepatic steatosis appears in 90% of individuals who abuse alcohol, 10-35% of that alcoholics develop alcoholic hepatitis, and that only 8-20% go on to develop alcoholic liver cirrhosis.