Von Hippelundau Disease

Alcohol Free Forever

Quit Drinking Alcohol

Get Instant Access





Gross Pathology Micro Pathology

Treatment Discussion

A 49-year-old male who is a known chronic alcoholic is brought to the emergency room with dehydration, jaundice, and fever; blood is drawn for routine tests, and he is infused with 5% dextrose, after which he becomes stuporous.

He had been admitted to the ER several times before for alcoholic gastritis and acute intoxication.

Patient confused and stuporous; normal fundus; nystagmus; skin and mucosal icterus; spider nevi on neck and upper chest; pitting pedal edema; abdominal distention with shifting dullness (= ASCITES); hepatosplenomegaly.

Increased serum bilirubin, predominantly direct; low serum albumin; increased serum AST and ALT (AST > ALT); markedly elevated gamma-glutamyl transferase (GGT); mildly elevated alkaline phosphatase; slightly prolonged PT; normal serum electrolytes and blood sugar; transudate revealed on ascitic fluid exam.

US/CT-Abdomen: hepatomegaly and splenomegaly with evidence of free fluid in peritoneal cavity.

Micronodular cirrhosis and fatty change of the liver.

Neutrophilic infiltrate; "Mallory hyaline bodies"; piecemeal necrosis and fibrosis surrounding central vein of portal triad on liver biopsy.

IV thiamine; complete abstinence from alcohol.

Caused by thiamine deficiency (most common cause is alcoholism). Alcoholics should receive thiamine before glucose to prevent this. p.235

Was this article helpful?

0 0
Supreme Sobriety

Supreme Sobriety

How to Maintain Your Resolution to Be Sober. Get All The Support And Guidance You Need To Be A Success At Sobriety. This Book Is One Of The Most Valuable Resources In The World When It Comes To Turning Your Love For Cooking Into A Money Maker.

Get My Free Ebook

Post a comment