Radiological and Biochemical aspect of Alcoholic Liver Disease: A Prospective study
Keywords:
Fatty Liver, Cirrhosis, Alcohol, Ascites, Alcoholic Liver Disease
Abstract
Background: Alcoholic cirrhosis is second leading indication for liver transplantation in United States and Europe. The spectrum of alcohol related liver injury varies from simple steatosis to cirrhosis; patients with alcoholic cirrhosis have high prevalence of complications at the time of cirrhosis diagnosis. So there is a need to study the radiology and underlying biochemical changes for early diagnosis to reduce morbidity and mortality in case of alcoholic liver disease.Methodology: the patients visiting the OPD of Medicine and suffering from ALD underwent through medical examination and then the severity of ALD was determined by radiological and biochemical findings. Patients who fulfilled the inclusion and exclusion criteria were enrolled in the study if they are willing to give written informed consent.Results: A total number of 30 male patients were studied, 17 patients had cirrhosis and 9 had fatty liver. Ascites was most common manifestation in both cirrhosis and fatty liver; followed by splenomegaly and portal hypertension in cirrhosis, whereas common bile duct dilatation was seen more in fatty liver. There were derangements in liver function tests associated with different stages of alcoholic liver disease but this was not statistically significant. There seem to be no statistically significant (p>0.05) correlation with the various biochemical parameters. Conclusions: Though a large number of radiological and biochemical changes are seen in cirrhosis and fatty liver, there seems to be no relation between these two. However the most common manifestation in both these conditions is ascites.References
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18. Narawane NM, Bhatia S, Abraham P, Sanghani S, Sawant SS. Consumption of ‘country liquor’ and its relation to alcoholic liver disease in Mumbai. J Assoc Physicians India 1998; 46: 510–3.
2. Iruzubieta P, Crespo J, Fabrega E. Long-term survival after liver transplantation for alcoholic liver disease. World J Gastrenterol 2013; 19: 9198-208.
3. Continuing Education in Anaesthesia, Critical and Pain, Volume 10; Number 3: 2010. Available at url: http://e-safe-anaesthesia.org/e_library/11/Alcoholic_liver_disease_CEACCP_2010.pdf (Last Assessed on 13th October, 2014)
4. Gao B, Bataller R. Alcoholic liver disease: Pathogenesis and new therapeutic targets. Gastroenterology 2011; 141: 1572-85.
5. Mendez-Sanchez N, Almeda-Valdes P, Uribe M. Alcoholic liver disease. An update. Ann Hepatol 2005; 4: 32-42.
6. Nyblom H, Berggren U, Balldin J et al. High AST/ALT ratio may indicate advanced alcoholic liver disease rather than heavy drinking. Alcohol Alcohol 2004;39:336–9.
7. Bird GL. Investigation of alcoholic liver disease. Baillieres Clin Gastroenterol 1993; 7; 663-82.
8. Keane MG, Lai C, Pereira SP. Detecting patients with cirrhosis in primary care. Practitioner 2014; 258 (1773): 15-20, 2-3.
9. Global Status Report on Alcohol 2004. Available at url. http://www.who.int/substance_abuse/publications/global_status_report_2004_overview.pdf. (Last Assessed on 13th October, 2014).
10. Ezzati M, Lopez A, Rodgers A, Vander Hoorn S, Murray CJ, Comparative Risk Assessment Collaborating Group. Selected major risk factors and global and regional burden of disease. Lancet 2002; 360: 1347–60.
11. Pessione F, Ramond MJ, Peters L, Pham BN, Batel P, Rueff B, et.al. Five-year survival predictive factors in patients with excessive alcohol intake and cirrhosis. Effect of alcoholic hepatitis, smoking and abstinence. Liver Int 2003; 23: 45–53
12. Borowsky SA, Strome S, Lott E. Continued heavy drinking and survival in alcoholic cirrhotics. Gastroenterology 1981; 80: 1405 – 9.
13. Brunt PW, Kew MC, Scheuer PJ, Sherlock S. Studies in alcoholic liver disease in Britain. I. Clinical and pathological patterns related to natural history. Gut 1974; 15: 52 – 8.
14. Luca A, Garcia-Pagan JC, Bosch J, Feu F, Caballeria J, Groszmann RJ, et.al. Effects of ethanol consumption on hepatic hemodynamics in patients with alcoholic cirrhosis. Gastroenterology 1997; 112: 1284-9.
15. European Association for the Study of the Liver. EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis. J Hepatol 2010; 53: 397–417.
16. D’Amico G, Garcia-Tsao G, Pagliaro L. Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies. J Hepatol 2006; 44: 217–31.
17. Mukhopadhyay P, Saha S, Philips CA, Sinha U. Clinical, biochemical and pathological correlation in alcoholic liver disease among Indian patients. Available at url. http://www.tropicalgastro.com/articles/33/3/clinical-biochemical-and-pathological.html. (Last Assessed on 13th October, 2014)
18. Narawane NM, Bhatia S, Abraham P, Sanghani S, Sawant SS. Consumption of ‘country liquor’ and its relation to alcoholic liver disease in Mumbai. J Assoc Physicians India 1998; 46: 510–3.
Published
2016-01-21
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