Esteatosis Hepatica
Hasta el momento he rehuido poner ningún caso de esteatosis hepática , llamado popularmente hígado graso. Tengo múltiples razones para ello. Una de las de mayor peso es que las imágenes sonograficas son de mala calidad, ya que una de sus características incluye la acumulación de material graso en las células hepáticas, por tanto, conociendo el hecho de que la grasa interfiere, por dispersión, los haces de sonido, el resultado es una imagen de mala calidad técnicamente hablando. Vemos pues una imagen hepática con aumento global de la ecogenicidad, contrastando fuertemente con la ecogenicidad del cortex renal y además con marcada disminución del calibre de las ramificaciones portas y de los canaliculos biliares intrahepaticos, los cuales parecen esfumarse.
Otra característica sonografica importante es que el hígado esta invariablemente aumentado de tamaño, condición sine qua non para el diagnostico.
Importante , como siempre, es la historia clínica del paciente, diabetes mellitus personal o familiar y el peso aumentado del paciente, aunque no todos los obesos tienen hígado graso.
Otra característica sonografica importante es que el hígado esta invariablemente aumentado de tamaño, condición sine qua non para el diagnostico.
Importante , como siempre, es la historia clínica del paciente, diabetes mellitus personal o familiar y el peso aumentado del paciente, aunque no todos los obesos tienen hígado graso.
Hoy mostramos caso de paciente masculino de solo 29 años de edad, obeso, que ingresa con dolor torácico retroesternal, disnea y mareos. Se le diagnostica Miocardiopatía hipertrofica hipertensiva. En su historia familiar destaca madre y padre con hipertensión arterial y de los seis (6) hermanos, dos (2) padecen la hipertensión hasta el momento. Tiene dos tíos maternos con Diabetes Mellitus . Entre sus familiares, dos tíos maternos y un primo por vía materna han fallecidos con muerte súbita, muertes relacionadas con la hipertensión.
En los últimos tiempos se ha abusado de este diagnostico, por sonografia, poniendo la etiqueta de hígado grado a todo el que esta en sobrepeso, somos muy cuidadosos y solo ponemos este diagnostico en los casos en que se cumplen todos o la mayoría de los parámetros
Fatty Liver
So far it refused to put any case of fatty liver. I have many reasons for that. One of the most important is that the images are of poor quality, since one of its features include the accumulation of fatty material in liver cells, therefore, knowing the fact that fat interferes, for dispersion, the beams of sound, the result is an image of a poor quality image as a technically speaking. We see the liver with an overall increase in echogenicity, contrasting sharply with the echogenicity of the renal cortex and also with a marked decrease in the size of the ramifications of the bile ports and intrahepatic canalicular, which seem to vanish.
Another important feature is that the liver is invariably increased in size, condition sine qua non for diagnosis.
Important, as always, is the patient's clinical history, diabetes, and personal or family the patient's weight increased, although not all obese have fatty liver.
Today show if only male patient 29 years old, obese, who was admitted with retrosternal chest pain, breathlessness, and dizziness. Hypertensive hypertrophic cardiomyopathy is diagnosed. On family history highlights mother and father with hypertension and for six (6) brothers, two (2) suffering from hypertension to date. He has two maternal uncles with Diabetes Mellitus. His family two maternal uncles and a cousin by the mother had died in sudden death associated with hypertension.
In recent times it has been abused by this diagnosis of fatty liver, putting the label to any degree of the liver which is in excess, we are very careful and only make this diagnosis in cases that meet all or most of the parameters.
Another important feature is that the liver is invariably increased in size, condition sine qua non for diagnosis.
Important, as always, is the patient's clinical history, diabetes, and personal or family the patient's weight increased, although not all obese have fatty liver.
Today show if only male patient 29 years old, obese, who was admitted with retrosternal chest pain, breathlessness, and dizziness. Hypertensive hypertrophic cardiomyopathy is diagnosed. On family history highlights mother and father with hypertension and for six (6) brothers, two (2) suffering from hypertension to date. He has two maternal uncles with Diabetes Mellitus. His family two maternal uncles and a cousin by the mother had died in sudden death associated with hypertension.
In recent times it has been abused by this diagnosis of fatty liver, putting the label to any degree of the liver which is in excess, we are very careful and only make this diagnosis in cases that meet all or most of the parameters.
