Hepatic Coma

Abstract

COMA is a terminal event frequently observed in patients with hepatic disease. This state is first characterized by lethargy or abnormal excitement and progresses to unconsciousness, often attended by convulsions, in the immediate period before death. The convulsions are most often focal but a localized brain lesion is seldom demonstrated at autopsy to explain them. The appearance of the disordered mental state, the convulsive episodes and the coma coincides with what appears to be serious metabolic decompensation. Fever, fetor hepaticus, deep "blowing-off" respirations, dryness of mucous membranes, muscular twitchings, oliguria and anuria are some of the findings suggestive of gross . . .