ACUTE HEPATIC INSUFFICIENCY OF THE CHRONIC ALCOHOLIC

Abstract

MOST CHRONIC alcoholics with active but uncomplicated cirrhosis demonstrate rapid improvement in their liver disease, in our experience, following hospitalization and consumption of an adequate diet. At times, however, acute severe hepatic functional impairment occurs, which may clear slowly or progress until the patient dies in hepatic coma. In this situation, the liver may show, in addition to fat and fibrosis, an extensive lesion characterized by hyaline degeneration and necrosis of parenchymal cells with leucocytic infiltration. This lesion, which was described by Mallory in 1911¹and which occurs in varying degrees of severity in many alcoholics, is so distinctive that it was decided to determine further its clinical significance. To do this, the present study was carried out, in which the clinical and pathological findings relating to the liver in 56 chronic alcoholics were analyzed. It was found possible to divide these cases, according to histological findings, into two