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Abstract: A 38-year-old young patient who had been drinking for 20 years presented to the hospital with recurrent nausea, vomiting, and right upper abdominal distension over the past 10 days. Laboratory liver function tests revealed abnormal liver function, and liver elastography suggested liver fibrosis. After examination, viral liver disease, autoimmune liver disease, and drug-related liver disease were excluded, and combined with his history of alcohol consumption, he was diagnosed with alcoholic liver fibrosis, which is a type of alcoholic liver disease. After medication and guidance on alcohol cessation, the patient recovered and was discharged.
[Basic information] Male, 38 years old
Type of disease】Alcoholic liver fibrosis
Hospital】The 988th Hospital of the PLA Joint Logistics and Security Forces
Date of consultation】March 2022
Treatment plan】Medication (magnesium isoglycyrrhizate injection + silymarin capsule + compound turtle shell soft liver tablet) + alcohol cessation guidance
Treatment period】20 days of inpatient treatment, 3 months of outpatient follow up
Treatment effect】The disease has been controlled and the liver function index has returned to normal.
I. Initial consultation
The patient was a 38-year-old male with a fat body shape, and abdominal obesity was especially obvious. At the time of consultation, he complained that he had lost 7-8 pounds in more than 10 days, could not eat, had poor appetite, had belching symptoms, and sometimes had vomiting and right upper abdominal distension after eating. The patient’s medical history showed that he had been physically fit in the past, but he had been drinking since he was 18 years old, and in the past 5 years, he had been drinking frequently due to his work, often to the point of drunkenness. Subsequently, liver function examination was performed, and it was found that glutamic aminotransferase, glutamic oxalacetic aminotransferase, alkaline phosphatase and glutamyl transpeptidase were significantly elevated, and liver elastography indicated liver stiffness of 27.7 kPa and liver steatosis value of 231 dB/m, so the diagnosis of alcoholic liver fibrosis was made.
II. Treatment history
After a clear diagnosis, the patient was admitted to the hospital for treatment. Although the patient had been drinking alcohol for a long time, he had not drunk alcohol for 1 month before admission due to ill health and did not have withdrawal syndrome, so after informing the patient of the harm of alcohol to the liver and the importance of the need to stop drinking, the patient expressed his intention to stop drinking and cooperate with the treatment. After being given magnesium isoglycyrrhizate injection to protect the liver and lower enzymes, silymarin capsule to detoxify and protect the liver cell membrane, and compound turtle nail soft liver tablet for anti-liver fibrosis treatment, the patient recovered and was discharged.
III. Treatment effect
After 20 days of inpatient treatment, the patient’s diet returned to normal, no more nausea and vomiting symptoms, sleep became better, right upper abdominal distension and pain disappeared, and liver function check, glutamate transaminase, glutamic oxalyl transaminase, alkaline phosphatase and glutamyl transpeptidase all returned to normal. After 3 months of outpatient follow-up after discharge, liver elastography was performed and liver stiffness index was found to have decreased to 15.9kPa.
IV. Notes
We are glad that the patient’s symptoms such as nausea and vomiting have been relieved after treatment. Because the patient has been drinking alcohol for 20 years and the drinking has increased dramatically in recent years due to how stressful work and life are, the physical status is problematic. The patient should be more deeply aware of the harm of alcohol and the importance of having a good body, so the patient is instructed to reduce the gathering of alcohol in the future, encourage the patient to go outdoors more often, develop other hobbies and enrich his spare time. Patients should also maintain good habits of life and rest, eat a reasonable diet, and consume more fresh vegetables and fruits to replenish vitamins. Family members should give the patient enough companionship and understanding to build up the patient’s confidence to successfully quit drinking.
V. Personal insight
Alcoholic liver disease is a disease in which excessive ethanol intake leads to liver damage, and this patient’s liver hardness value is significantly elevated and has reached the degree of liver fibrosis. Fortunately, complications such as ascites and gastrointestinal bleeding have not yet appeared, and it is not too late to start quitting alcohol, and the patient and his family are willing to actively cooperate through treatment and achieve significant results.
As a special Chinese culture in life, alcohol culture has a unique place in social and work life. Proper and moderate drinking will bring some pleasure to life, but long time drinking, heavy drinking, and drinking with a fluke mentality will generally lead to addiction unknowingly and turn into alcohol dependence, which will damage the body.