Alcoholic Hepatitis Case Study

This patient’s history of alcohol abuse directly relates to the development of this patient’s end stage liver complications. The patient’s alcoholic cirrhosis denotes that the patient has developed this irreversible disease over the span of years that have gone undetected and untreated, that begun with alcoholic hepatitis and progressed all the way to alcoholic cirrhosis, due to the overconsumption of alcohol and his socioeconomic status (homeless). Alcoholic hepatitis is characterized by inflammation of the liver. In hepatitis, the inflammatory response causes edema to form in the liver and obstruct the bile canaliculi, possibly causing liver cell necrosis, Kupffer cell hyperplasia, and scarring. Hepatitis in this way can be caused by drinking large quantitied of alcohol in a relatively …show more content…
Portal hypertension is responsible for the formation of splenomegaly (seen in pt’s ultrasound) and ascites (pt currently has). When blood flow is obstructed through the portal vein, the following increase in pressure in the splenic vein causes an enlarged spleen and increased rate to blood cell destruction → thrombocytopenia anemia → more platelets removed from circulation and sequestered in the spleen → impaired clot formation → esophageal bleeding. In ascites, there is an accumulation of protein rich fluid in the abdominal cavity. Though portal hypertension is the primary cause of ascites, hypoalbuminemia(Low albumin → decrease in colloidal osmotic pressure in BV → fluids escape to interstisial spaces→ decreases blood volume→ kidneys retain water and sodium→ increase in hydrostatic pressure, excacerbating portal hypertension and ascites formation). and the accumulation of aldosterone contribute to fluid accumulation. Care of the patient is currently focused on pain relief and on improving