HEPATOPATÍAS AGUDAS

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Florencia
 
Hepatitis aguda
 Hepatitis crónica

 Cirrosiis
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HEPATITI
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  Es un proceso inflamatorio que compromete al
parénquima hepático

 Etiología:
 Agentes virales: A, B, C, D, E, G, citomegalovirus

(CMVV), Epsttein Barr

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 HEPATITIS VIRAL
o
AGUDA
Es una enfermedad infecciosa del hígado causada por 
distintos virus que tienen un especial tropismo hepático y que
se caracteriza por necrosis hepatocelular e inflamación

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 CUADRO
Curso CLÍNICO
clínico 4
Periodos:

Incubación:
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exposición
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Prodrómico: a hepatitis B y C y menos en la A y en la
ser 
  Laboratorio:

  Aumento de las transaminasas GOT Y GPT (20- 40

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dos fracciones
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 Hepatitis A Hepatitis B Hepatitis C Hepatitis D Hepatitis
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 RNA
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TRATAMIENT
O 
 No existe tratamiento específico de la hepatitis

 A y E. Medidas de sostén
 Hepatitis B: forma benigna no
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 HEPATITIS CRÓNICA
 Enfermedad inflamatoria crónica del hígado cuyo
sustrato morfológico se caracteriza en la asociación de
fenómenos inflamatorios, necrosis celular y en muchos
casos fibrosis.
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 CUADRO CLÍNICO
 


  Astnetnoiam, átdci oalor en hipocondrio derecho, molestias

poco específicas
 Casos graves o avanzados: manifestaciones propias de

eennefermmeeddaadd ica, ictericia, ascitis

hheepstores
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 
Clasificación
De acuerdo a sus alteraciones histológicas, la
hepatitis crónica se clasifica en:
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  Hepatitis Crónica
Persistente: 
Se caracteriza por infiltrado inflamatoria leve en
los tractos portales, mientras que la
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 
Hepatitis Crónica Lobulillar:

Se manifiesta con rasgos de hepatitis aguda con

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  Hepatitis Crónica
Activa:
En ella existe un infiltrado inflamatorio crónico, que
expande las áreas portales y se extiende a los
lóbulos, con erosión de la placa limitante y
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  Hepatitis Au toinmu n e  

Mujeres adolescentes. Predisposición genética y

presencia de autoanticuerpos
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 TRATAMIENT
O 

Hepatitis B: dosis diario de 5 a 10 UI interferón
tres veces por semana, durante 16 semanas.
 Análogos de nucleósidos (lamiduvina, entecavir) o
nucleótidos (adefovir)
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CIRROSIS
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  La cirrosis es la fase mas avanzada de
la mayoría de las enfermedades
caracterizada por fibrosis hepática
hepáticas
progresiva.
 L Laa fibbrroossiss la consecuencia de la reparación
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 ETIOLOGÍ
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 Consumo abusivo de alcohol

 Hepatitis víricas

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  Clasificación morfológica:

 Macronodular (mayoría de los

nódulos con tamaño superior a 3 mm)

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 CLÍNICA
 

Inespecíficos: astenia, anorexia
 En fases avanzadas complicaciones secundarias a

hipertensión portal o insuficiencia

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 DIAGNÓSTIC
O 
• EXPLORACIÓN FÍSICA


Hepatomegalia con bordes

duros
•  AEsplenomegalia
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  PRUEBAS DE LABORATORIO

 Transaminasas elevadas
 Relación GOT/GPT mayor

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  PRUEBAS DE IMAGEN
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 TRATAMIENT
O 
 Varices esofágicas: profilaxis de la hemorragia

digestiva mediante la administración de

Betabloqueantes no selectivos
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 COMPLICACIONES
 
 Son las causas mas frecuentes de muerte por criossi:

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  Se
HEPATOPATÍA ALCOHOLICA
considera que la ingesta necesariapara
desarrollar una cirrosis es de 1 gr de alcohol por día
durante periodos prolongados de tiempo
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 hipovitaminosi
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CIRROSIS BILIAR PRIMARIA

 
Enfermedad hepática poco frecuente que afecta
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II I I - - ll
  Cuadro clínico:

 Prurito: palmas de manos y plantas de pies.

Casos avanzados todo el cuerpo
 Iccteerricciaa: s s
eeace más intensa con el transcurso
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  Laboratorio:

 Bilirrubina conjugada
elevada
 FAL elevada
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 
TRATAMIENTO
 Ácido ursodesoxicólico   13- 15 mg/kg de
peso por día de por vida.
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