Medical and Surgical Problems in Liver Disease

Abstract

Treatment of hepatitis consists principally of bed rest and a high calorie, high protein diet with added vitamins; in relapsing hepatitis, corticosteroids also may help.

Emergency treatment, necessary for patients with hemorrhage from esophageal varices, includes blood transfusions, tamponade to control bleeding, and removal of blood to prevent hepatic encephalopathy. Surgical procedures include splenorenal and portacaval shunting operations, esophagogastrectomy, and hepatic and splenic arterial ligations; the latter are still in an experimental stage. Percutaneous splenic portography is of value in selecting the type of shunting procedure.

In hepatic cirrhosis the prothrombin level has prognostic significance.

Often the only way to differentiate primary biliary cirrhosis and the extrahepatic variety is by liver biopsy.