DISEASES OF THE LIVER AND BILIARY TRACT : THE SYPHILITIC HEPATITIS (HEPATITIS LUETICA) - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
Developed in the tertiary period of syphilis. There are two forms:
The formation of miliary gum in interstitial tissue, endarteritis and periarteritis, productive-inflammatory process with the development of connective tissue, scarring and shrinkage of the liver (miliano-hummocky diffuse process). The second form of focal-hummocky hepatitis C education unit of gum, development around the connective tissue, scarring her and ethnoregional large areas of the liver (hepar lobatum). Gum sometimes nagnaivajutsja, softened, can provide a breakthrough in adjacent organs.
In the diffuse hepatitis liver (mainly the left lobe) is enlarged, smooth, has a rough edge. Over time develop reduction and small roughness of the liver, reminiscent of the atrophic stage of cirrhosis (see chronic Hepatitis). With a focal hepatitis liver krupnoporistoj, there are often characterized delicately. Along with dense mounds, there are areas of softening and fluctuations. Sharp pain - self and palpation. Frequent nocturnal pain. The most important symptom is fever remittent type, accompanied by chills. Despite the duration of fever, the General condition of patients not suffering, loss of appetite persists. Jaundice is rare. The functional state of the liver a little disturbed. Anemia is not expressed. Blood monocytosis. Enlargement of the spleen - a sign of non-permanent. The disease has a progressive character. Due to the shrinkage of the liver, as well as violation of its functions may appear ascites, more significant enlargement of the spleen or obstructive jaundice. Sometimes there is accession degenerative lesions of the liver cells with jaundice. Sometimes lobed liver little worried sick and is finding during examination of patients with syphilis of the aorta.
Recognition is difficult in the diffuse form, reminiscent of nonspecific cirrhosis of the liver. Diferencialna diagnostic value has a fever, a positive Wasserman, other manifestations of syphilis.
Prediction is always serious. Only in the initial stages you can expect significant improvements.