Gastroenterology in Critical CareHepatitis

I. Hepatitis.
A. Inflamation of the Liver.
B. Usually Viral.
C. May be caused by alcohol or other toxins.
D. Globules of the liver swell then slough off.
E. Healing causes disruptions of the bile cannel.
F. Bile can't be excreted causes increase in liver function tests. (LFT).

II. Stages of Hepatitis.
A. Preenteric Phase.
1. Malaise, Flu like symptoms.
2. G.I.- Nausea, Vomiting, Anorexia.
3. Headache, Fatigue.
4. Right upper quadrant tenderness.
B. Enteric Phase.
1. Prevents bilirubin from being excreted.
*a. Bilirubin spills to the blood.
*b. Jaundice - affects skin, mucus membrane, eyes become
yellow.
*c. Itching of the skin from bile salts irritation.
2. Light clay colored stools - no pigment.
3. Urine becomes dark brown.
4. Flu like symptoms decreases but LFT remains increased.
C. Post enteric phase.
1. Last for several weeks.
2. Symptoms decrease.
3. LFTs improve.
4. No treatment it has to run its course.
D. Hepatitis can progress to more life threatening diseases.

Hepatitis A.
  1. Transmitted by the Fecal/Oral route.
  2. Raw seafood.
    Contaminated Water.
    3. Poor Sanitation.
    4. Usually affects older children and young adults.
    B. Where Found.
    1. Incubation period is 15-50 days.
    2. May be found in stools two weeks before symptoms appear.
    C. Clinical onset is abrupt.
    D. Diagnostic Test is serum antibodies.
    E. Prophylaxis.
    1. Immune Gamma Globulin A. (IGG A).
    P. Risk Group.
    1. Children in day care.
    2. International Travelers.
Hepatitis B.
A. Transmitted by blood and blood products.
B. Risk Group.
1. Health Care workers.
2. Young adults.
3. Immigrants.
4. Drug users.
C. Clinical Onset is Insidious.
D. Diagnostic Test.
1. Hepatitis B surface antibody screen.
E. 10% develop subsequent chronic disease.
P. Incubation Period.
1. 60-120 days.
Hepatitis C.
A. Affects all age groups.
B. Transmitted by infected blood.
C. Clinical onset is insidious.
1. Travelers.
2. IV drug use.

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This page last updated 11/04/00