Man, 44, suffered hematemesis prior to fatty liver disease diagnosis

Liver Disease: Expert discusses risks and symptoms

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Fatty liver disease, which is also known as non-alcoholic fatty liver disease, refers to a range of liver conditions that are not linked to alcohol. The primary cause of fatty liver disease is having too much fat stored in the liver. In its early stages it often remains symptomless, meaning it can go undiagnosed.

However, it can lead to liver scarring – known as cirrhosis – and, ultimately, liver failure.

Prior to cirrhosis, patients could also experience non-alcoholic steatohepatitis (NASH), where the liver becomes inflamed and fibrosis, which causes scar tissue around the liver and nearby blood vessels.

This was the case for one 44-year-old man, whose story was published in Case Reports in Gastroenterology.

Before being admitted to hospital he suffered from hematemesis – vomiting blood.

The study explained: “A 44-year-old male was emergently admitted to our hospital because of hematemesis due to the rupture of gastroesophageal varices.

“Prior to admission, he had no remarkable medical history.

“There was no family history of liver diseases. He was not a habitual drinker and did not take other drugs.”

An ultrasound examination on his abdomen revealed surface “irregularity”, “dullness” of the edge of the liver and an enlarged spleen.

“Contrast-enhanced computed tomography (a CT scan) demonstrated enlargement of the left hepatic lobe (one quarter of the liver) and splenomegaly (enlarged spleen), which corresponded to liver cirrhosis.”

It also showed “active” bleeding from gastroesophageal varices, which was the cause of the hematemesis.

The study said: “The histological findings of liver biopsy were mild steatosis (a build-up of fat in the liver), mild chronic inflammatory cell infiltrate, and severe fibrosis in the expanded portal areas with bridging fibrosis and spotty or focal necrosis.

“Based on these findings, the patient was diagnosed with portal hypertension and liver cirrhosis due to NASH.”

Causes of fatty liver disease

In the case of this patient, the medical staff ruled the cause of disease as obesity.

Two years before admission, his body weight was 120 kilograms (kg), and his body mass index (BMI) was 40.5.

On admission, his body weight was 116.7kg and his BMI was 39.4.

According to the NHS, a BMI of between 18.5 and 24.9 is considered healthy.

The study added: “As obesity and metabolic syndrome have become more prevalent, nonalcoholic fatty liver disease (NAFLD) has emerged as a common cause of chronic liver diseases.

“In conclusion, we should be aware of the possibility of NASH with liver fibrosis and carefully monitor its complications in patients with long-term severe obesity.”

Other known causes of fatty liver disease are:

  • Having type 2 diabetes
  • If you are insulin resistance, such as polycystic ovary syndrome
  • An underactive thyroid
  • High blood pressure
  • High cholesterol
  • Metabolic syndrome (a combination of diabetes, high blood pressure and obesity)
  • If you are over the age of 50
  • Smoking.

And symptoms can include:

  • A dull or aching pain in the top right of the tummy (over the lower right side of the ribs)
  • Extreme tiredness
  • Unexplained weight loss
  • Weakness.

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