What are the basic functions of the liver?
The liver is an important chemical plant in the human body. Its main physiological functions are metabolism, bile secretion and detoxification. Its metabolic functions are mainly five major metabolic functions such as sugar, protein, fat, vitamins and hormones. The detoxification function, also known as biotransformation function, is to metabolize and transform various biologically active substances (such as hormones, neurotransmitters, etc.) produced by human metabolism, various foreign substances (including drugs, pesticides, etc.) and poisons that enter the body from outside, as well as corrupt substances (such as indoles, phenols, etc.) absorbed by the intestine, in the liver cells. When the liver is damaged, the detoxification function of the liver decreases, and the patient develops symptoms of toxicity.
What are “liver palms” and “spider nevus”?
Liver palm refers to the appearance of dense patches and patches of bright red on the palms of patients with chronic liver disease, which is most obvious on the palm surface of the fingertips between the small and large fissures, and also on the bottom of the feet. This phenomenon can also be seen in rheumatoid arthritis, malnutrition, malignant tumors and alcoholics. The severity of the liver palm is a reference value for determining the condition of chronic hepatitis.
Spider nevus is also called star-shaped nevus and spider-shaped hemangioma. It is named after the spider-like nevus, which consists of thread-like arterial microvessels arranged radially from the central point to the surrounding area.
What does hepatic coma mean and what causes it?
Due to severe damage to the liver, toxic metabolites in the blood cannot be removed, or toxic substances in the portal blood bypass the liver and enter the body circulation from the collateral circulation, which most often leads to central nervous system dysfunction and causes coma. Because this coma originates from liver lesions, it is called hepatic coma, or hepatic encephalopathy (with brain dysfunction as the main cause). Hepatic coma is a serious comorbidity of liver disease and an important cause of death.
There are several reasons for the occurrence of hepatic coma, such as
1.Gastrointestinal bleeding
2.The application of diuretics
3.Application of sedatives and anesthetics
4.Large amount of ascites release
5, excessive intake of protein food
6.Infection
7.Constipation
Why do patients with chronic liver disease have a sallow complexion?
Patients with chronic liver disease, including patients with cirrhosis and liver ascites, often have a darker facial skin color, losing their original color and appearing to be stained, called sallow. This particular look is called the liver disease face. The main mechanism for the formation of this face is: the increase of estrogen in the body, so that the inhibition of tyrosinase by the sulfur hydrogen group in the skin is weakened, resulting in an increase in the amount of tyrosinase into melanin, deposited in the skin, so that the skin becomes dark. It is also believed that patients with cirrhosis have hypoadrenalism, and the adrenal medulla synthetically governs the reduced function of the adrenal glands, which affects pigment metabolism, and pigments enter the skin, making the skin darker. In addition, patients with cirrhosis have a weakened sympathetic inhibition of melanogenesis, which leads to increased melanogenesis and pigment entry into the skin, resulting in the appearance of sallow complexion.
Why do patients with liver disease often have dysesthesia?
Patients with hepatitis often complain of “hypochondriacalgia”, which should actually be called “hepatic pain”. There are several reasons for the occurrence of hypochondriac pain in liver disease.
(1) Stretching and dilatation of the hepatic tegument.
In patients with hepatitis, congestion, exudation, hepatocellular swelling, and intrahepatic bile accumulation occur in the liver, causing rapid enlargement of the liver and stretching and expansion of the hepatic peritoneum, causing pain by pulling and stimulating the phrenic nerve branch endings in the hepatic peritoneum.
(2) Periportal hepatitis.
In viral hepatitis, in addition to lesions in the hepatocytes, reactive inflammation occurs in the perihepatic tissues, forming perihepatitis, which may cause pain due to adhesions with nearby tissues or organs.
(3) Parenchymal inflammation of the liver.
As a result of diffuse lesions in the liver, some nerve endings deep within the liver can be stimulated by inflammation and cause pain.
(4) Inflammation of extrahepatic organs.
Lesions in the liver often involve the gallbladder and biliary system, causing inflammation of the gallbladder and biliary tract or inflammation around the gallbladder, and these lesions can cause pain in the liver area.
Pain in the flank is an important symptom in patients with hepatitis, but it is not the case that hepatitis is caused by pain in the flank. Because hepatic tumors and biliary disorders are associated with flank pain, and sometimes intercostal neuralgia and inflammation of the costal cartilage are confused with hepatic pain, a thorough analysis should be made in conjunction with other symptoms, signs, and laboratory results.
Why does ascites occur in liver disease?
Ascites is one of the most prominent symptoms of cirrhosis. Patients with liver disease who do not develop ascites after cirrhosis are in the early stage of cirrhosis, or called the compensated stage of cirrhosis; once ascites appears, they are in the late stage of cirrhosis, or called the decompensated stage. There are several reasons for the appearance of ascites, as follows
(1) Hepatocellular damage: When hepatocellular damage is severe, it affects the manufacture of albumin, which decreases the colloid osmotic pressure of blood, and the water in the blood leaks out from the blood vessels into the abdominal cavity. At the same time, the detoxification and inactivation of the liver is diminished, leading to disorders of hormone metabolism and causing sodium and water retention, thus causing ascites.
(2) Intrahepatic vascular obstruction: In cirrhosis, due to the destruction of the structure of the liver lobules and the proliferation of fibrous tissue, the intrahepatic vascular bed is compressed, narrowed, distorted and modified, which eventually leads to a significant reduction in the hepatic vascular bed and hepatic blood flow, among which the hepatic venous system is damaged at the earliest and obviously, so that the blood output is significantly lower than the input from the hepatic artery of the portal system, resulting in an increase in portal pressure and capillary venous pressure, producing Ascites is obvious and often persistent. In addition, obstruction of lymphatic flow is also a cause of ascites.
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