Điều trị: Điều trị bao gồm chủ yếu là chăm sóc hỗ trợ, như các bệnh nhân hiếm khi đòi hỏi phải nhập viện. Tám mươi lăm phần trăm của bệnh nhân sẽ có một hồi phục hoàn toàn lâm sàng trong vòng 3 tháng. | DISORDERS OF THE LIVER GALL BLADDER AND PANCREAS 49 TAB LE 2-3 CAUSES OF ACUTE AND CHRONIC HEPATITIS CONDITION CAUSE EXAMPLES Acute hepatitis Viral Hepatitis A B C D EBV CMV Toxins Alcohol Carbon tetrachloride Mushroom poisoning Ammanita phalloides Drugs Acetominophen Isoniazid Halothane anesthesia Chlorpromazine Erythromycin Chronic hepatitis Viral Hepatitis B C D 6 mo Drugs Methyldopa Amiodamone Isoniazid Idiopathic Autoimmune features Inpoid hepatitis No autoimmune features Metabolic liver disease Wilson disease a-Antitrypsin deficiency Tintinalli JE Kelen GD Stapczynski JS. Emergency Medicine A Comprehensive Study Guide. 5th ed. New York McGraw-Hill 2000 p. 580. Treatment Treatment consists primarily of supportive care as patients rarely require hospital admission. Eighty-five percent of patients will have a full clinical recovery within 3 months. Fatalities occur more commonly in the elderly and patients with chronic hepatitis C. Hepatitis B Etiology Hepatitis B virus HBV is a DNA virus spread percutaneously or through blood and bodily fluids. Clinical Presentation HBV incubation period lasts 1-4 months. A prodromal period is followed by constitutional symptoms such as anorexia nausea jaundice and RUQ pain. The symptoms typically 50 CHAPTER 2 ABDOMINAL AND GASTROINTESTINAL DISORDERS disappear after 1-3 months in cases of acute hepatitis B. Progression from acute to chronic HBV infection or to chronic carrier state is linked to the age at infection with HBV. If HBV is acquired in the perinatal period there is a 90 progression to the chronic carrier state. There is only a 20-50 conversion from the acute to chronic state of HBV infection if it is acquired between ages 1-5 years old. In adult acquired infection there is 5 progression to the chronic HBV infection state. Chronic HBV patients may have no symptoms decompensated cirrhosis or nonspecific symptoms like malaise. Fulminant liver failure occurs in 1 ofpatients with acute HBV infection. Chronic HBV infection
