Liver failure or hepatic insufficiency is the inability of the liver to perform its normal synthetic and metabolic function as part of normal physiology. Two forms are recognised, acute hepatic encephalopathy diet pdf chronic.
The disease process is associated with the development of a coagulopathy of liver aetiology, and clinically apparent altered level of consciousness due to hepatic encephalopathy. Several important measures are immediately necessary when the patient presents for medical attention. The diagnosis of acute liver failure is based on physical exam, laboratory findings, patient history, and past medical history to establish mental status changes, coagulopathy, rapidity of onset, and absence of known prior liver disease respectively.
The exact definition of “rapid” is somewhat questionable, and different sub-divisions exist which are based on the time from onset of first hepatic symptoms to onset of encephalopathy. One scheme defines “acute hepatic failure” as the development of encephalopathy within 26 weeks of the onset of any hepatic symptoms. This is sub-divided into “fulminant hepatic failure”, which requires onset of encephalopathy within 8 weeks, and “subfulminant”, which describes onset of encephalopathy after 8 weeks but before 26 weeks. Another scheme defines “hyperacute” as onset within 7 days, “acute” as onset between 7 and 28 days, and “subacute” as onset between 28 days and 24 weeks.
Acute on chronic liver failure” is said to exist when someone with chronic liver disease develops features of liver failure. A number of underlying causes may precipitate this, such as alcohol misuse or infection. People with ACLF can be critically ill and require intensive care treatment, and occasionally a liver transplant.
Acute liver failure: redefining the syndromes”. Acute-on-Chronic Liver Failure: A Distinct Clinical Condition”.
De dubbele secretie- of afscheidingsfunctie van dit orgaan bestaat uit uitwendige afscheiding ten behoeve van de spijsvertering, en inwendige afscheiding ten behoeve van de koolhydraatstofwisseling. De alvleesklier produceert en scheidt 1,5 à 3 liter alvleessap per dag af. Het alvleessap bevat inactieve spijsverteringsenzymen, zoals trypsine, amylase, lipase en protease. Deze enzymen worden pas in het duodenum geactiveerd om afbraak van de alvleesklier door zijn eigen enzymen te voorkomen.