Asymptomatic liver disease in alcoholics.

Several types of histologic changes of the liver have been found in 116 of 154 chronic alcoholics who showed no symptoms of organic liver disease and were admitted to a department of psychiatry for treatment of their addiction. No relation was found either between the nature of the hepatic damage and the duration of alcoholism or with the presence of degree of clinical and biochemical disturbances. Results of clinical and biochemical examination of 55 patients with histologic abnormalities were normal, and these patients were considered as apparently healthy alcoholics.

Upper gastrointestinal bleeding in cirrhosis: clinical and endoscopic correlations.

The clinical data of 180 episodes of upper gastrointestinal bleeding in 168 patients with cirrhosis of the liver are examined. The source of bleeding had been determined by early endoscopy in all cases. In men under the age of 50 years, and without symptoms of liver failure, bleeding was due to ruptured gastro-oesophageal varices in 84% of cases.

[Esophageal manifestations of pemphigus vulgaris].

The fibroscopic examination of a case of pemphigus vulgaris is described. The author postulate the fibroscopy as routine examination in the pemphigus with oral lesions.

Hypernatremia following gastrointestinal bleeding in cirrhosis with ascites.

3 patients with hepatic cirrhosis and ascites underwent increased diuresis on six occasions, closely related to episodes of gastrointestinal bleeding. In each instance the increased urine volume was preceded by a sharp increase in blood urea nitrogen, presumably due to absorption of nitrogenous compounds from the gastrointestinal tract, suggesting a mechanism of osmotic diuresis. In each case there was a signigicant increase in serum sodium and osmolality, related to the greater-water-than-sodium diuresis induced by urea, which was promptly reversed by the administration of water or isotonic solution.

A comparison of the accuracy of peritoneoscopy and liver biopsy in the diagnosis of cirrhosis.

The accuracy of peritoneoscopy and liver biopsy in the diagnosis of hepatic cirrhosis was compared in 473 consecutive patients submitted to both procedures. One hundred and fifty-two of them had cirrhosis diagnosed by one or both methods. There was 73% agreement between the two procedures.