Understanding Acute Hepatitis, Cirrhosis, and Cholecystitis

Acute Hepatitis: An Overview

Acute hepatitis is a necroinflammatory liver disease caused by infection from hepatitis viruses A, B, C, D, and E. The key difference between acute and chronic hepatitis is the duration, with the distinction typically made at 6 months.

Hepatitis A

Hepatitis A is caused by an RNA virus. Transmission is typically fecal-oral and can, in rare cases, be fatal, leading to fulminant hepatitis.

Epidemiology

Hepatitis A often occurs in cycles every 5 to 10 years, with seasonal predominance in childhood. The infection spreads through the fecal-oral route, often via contaminated food and water. Parenteral transmission is rare.

Symptoms

Symptoms include coluria (dark urine) followed by scleral icterus (jaundice) and hypocholia (pale stools).

Diagnosis

Diagnosis involves observing an increase in transaminases, starting at the end of the incubation period, which typically returns to normal within 2 months.

Prevention and Treatment

Prevention includes good sanitary control of water and thorough handwashing. A vaccine exists and is recommended for at-risk groups.

Hepatitis B

Hepatitis B is caused by a DNA virus and can be either acute or chronic. In some cases, it progresses to cirrhosis or carcinoma.

Epidemiology

Hepatitis B is a global problem, spread through blood. Children are rarely infected via transfusion.

Clinical Presentation

Clinical manifestations include perinatal acute jaundice, chronic hepatitis, urticaria, asthenia, anorexia, and functional impairment lasting more than 6 months. The condition usually evolves favorably.

Diagnosis

Diagnosis involves elevated transaminases, detection of surface and core antigens, and DNA analysis.

Treatment

Treatment includes interferon alpha. Vaccination is administered to newborns and adolescents, with a 30-40% success rate.

Hepatic Cirrhosis

Cirrhosis originates from a word meaning yellow. It is a chronic and diffuse disease of the liver, diagnosed definitively by biopsy.

Pathology

Pathological features include necrosis, fibrosis, and regenerative nodules. Compensated cirrhosis may be discovered during clinical examination due to symptoms like bloating, heavy digestion, angionas, and nosebleeds.

Clinical Presentation

Decompensated cirrhosis presents with ascites, hepatic encephalopathy, gastrointestinal bleeding, and can evolve into liver cancer.

Treatment

Treatment involves a free and balanced diet, prohibition of alcohol, and avoidance of hepatotoxic drugs and anabolizantes.

Cholecystitis

Cholecystitis is the inflammation of the gallbladder, almost always due to calculous obstruction of the cystic duct, followed by bacterial infection of the walls.