CHAPTER 7 Gastrointestinal System^309
PROGNOSIS
Hepatitis may occur as an acute infection (viral type A, E) or become a chronic
state. The patient with chronic disease may be unaware of the illness until testing
of liver function shows abnormalities and further testing reveals presence of hep-
atitis. The chronic (viral type B, C) disease state creates the potential development
of progressive liver disease. Some patients with chronic disease will need liver
transplant. Recurrence rate post-transplant is high. Liver cancer may develop in
those with chronic disease states.
HALLMARK SIGNS AND SYMPTOMS
- Acute hepatitis:
- Malaise
- Nausea and vomiting
- Diarrhea or constipation
- Low-grade fever
- Dark urine due to change in liver function
- Jaundice due to liver compromise
- Tenderness in right upper quadrant of abdomen
- Hepatomegaly
- Arthritis, glomerulonephritis, polyarteritis nodosa in hepatitis B
- Chronic hepatitis:
- Asymptomatic with elevated liver enzymes
- Symptoms as acute hepatitis
- Cirrhosis due to altered liver function
- Ascites due to decrease in liver function, increased portal hypertension
- Bleeding from esophageal varices
- Encephalopathy due to diminished liver function
- Bleeding due to clotting disorders
- Enlargement of spleen
INTERPRETING TEST RESULTS
- AST elevated.
- ALT elevated.