Factors Precipitating Hepatic Encephalopathy

Consider the liver like a visa officer who approves entry for incoming substances from the GI Track. For 'Toxins', the visas are rejected, they are arrested, detained for questioning and either directly destroyed or 'rehabilitated' to another form and excreted - like Ammonia is thrown out in the form of Urea.

When toxic substances (especially Ammonia) are either in relative excess (diseased liver and/or increased incoming toxins) and/or jump the fence bypassing the liver via Porto-systemic shuts [Illegal immigrants ;-)] , hepatic encephalopathy can occur.

Here's a way to remember the main factors / conditions known to precipitate hepatic encephalopathy / coma.

"HEPATICS"

H - Hemorrhage in GIT
E - Excess Protein in diet
P - Potassium depletion (Diuretics, rapid Paracentesis)
A - Alkalosis, Azotemia
T - Trauma
I - Infection (Bacterial Peritonitis and others)
C - Constipation, Colon surgery
S - Sedatives


So now - since you know the factors that can precipitate or aggravate hepatic encephalopathy - management of a hepatic enceph. patient is easily derivable from the same !



Search keywords to this article

- "factors that can result in hepatic coma"
- "precipitating factors for hepatic encephalopathy"

Remembering Fitz Hugh Curtis Syndrome

Remember the F.H.C. syndrome as Fibrotically-fixed Hepatic Capsule : this happens due to fibrotic adhesions that develop around the liver capsule following Pelvic Inflammatory Disease in women...

This is a rare complication of PID due to Gonococcus or Chlamydia...

And in the process do not forget that FHC originally stood for Fitz Hugh Curtis ..lol