Fatty hepatosis code for ICD. Alcoholic fatty liver

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What is fatty liver: ICD code 10

The development of fatty hepatosis is based on the violation of metabolic processes in the human body. As a result of this liver disease, healthy tissue of the organ is replaced by fatty tissue.

At the initial stage of development, fat accumulates in hepatocytes, which over time simply leads to dystrophy of the liver cells.

If the disease is not diagnosed at an early stage and appropriate therapy is not carried out, then irreversible inflammatory changes occur in the parenchyma, which lead to the development of tissue necrosis. If fatty liver is not treated, it can develop into cirrhosis, which is no longer treatable. In the article, we will consider the reason for the development of the disease, methods of its treatment and classification according to ICD-10.

Causes of fatty liver and its prevalence

The causes of the development of the disease have not yet been exactly proven, but factors are known that can surely provoke the onset of this disease. These include:

completeness;
diabetes;
violation of metabolic processes (lipid);
minimal exercise stress with a nutritious daily diet high in fat.

Most cases of development of fatty hepatosis are recorded by physicians in developed countries with above-average living standards.

There are a number of other factors associated with hormonal disruptions, such as insulin resistance and the presence of sugar in the blood. You can not omit the hereditary factor, it also plays a big role. But still, the main reason is malnutrition, a sedentary lifestyle and excess weight. All causes are in no way related to the intake of alcoholic beverages, so fatty hepatosis is often called non-alcoholic. But if alcohol addiction is added to the above reasons, then fatty hepatosis will develop many times faster.

In medicine, it is very convenient to use the coding of diseases to systematize them. It is even easier to indicate a diagnosis on a sick leave using a code. Codes for all diseases are presented in International classification diseases, injuries and various health problems. The tenth revision is currently in effect.

All liver diseases according to the International Classification of the Tenth Revision are encrypted under the codes K70-K77. And if we talk about fatty hepatosis, then according to ICD 10, it falls under the code K76.0 (fatty degeneration of the liver).

You can learn more about the symptoms, diagnosis and treatment of hepatosis from separate materials:

Treatment of fatty liver

The treatment regimen for non-alcoholic hepatosis is to eliminate possible risk factors. If the patient is obese, then you need to try to optimize it. And start by reducing the total mass by at least 10%. Doctors recommend using minimal physical activity in parallel with dietary nutrition to achieve the goal. Limit the use of fats in the diet as much as possible. At the same time, it is worth remembering that a sharp weight loss will not only not be beneficial, it can, on the contrary, damage, aggravating the course of the disease.

For this purpose, the attending physician may prescribe thiazolidinoids in combination with biguanides, but this line of drugs has not yet been fully studied, for example, for hepatotoxicity. Metformin can help correct the process of metabolic disorders in carbohydrate metabolism.

As a result, we can confidently say that with the normalization of the daily diet, a decrease in body fat and giving up bad habits, the patient will feel better. And only in this way it is possible to fight such a disease as non-alcoholic hepatosis.

Source: http://zapechen.ru/bolezni-pecheni/gepatoz/mkb-10.html

LIVER DISEASES (K70-K77)

Included: medicinal:

idiosyncratic (unpredictable) liver disease
toxic (predictable) liver disease

Use an additional external cause code (class XX) if necessary to identify the toxic substance.

Excluded:

Budd-Chiari syndrome (I82.0)

Included:

hepatic:
- coma NOS
- encephalopathy NOS
hepatitis:
- fulminant, not elsewhere classified, with liver failure
- malignant, not elsewhere classified, with liver failure
liver (cell) necrosis with liver failure
yellow atrophy or liver dystrophy

Excluded:

alcoholic liver failure (K70.4)
liver failure complicating:
- abortion, ectopic or molar pregnancy (O00-O07, O08.8)
- pregnancy, childbirth and the puerperium (O26.6)
fetal and neonatal jaundice (P55-P59)
viral hepatitis (B15-B19)
associated with toxic liver damage (K71.1)

Excludes: hepatitis (chronic):

alcoholic (K70.1)
medicinal (K71.-)
granulomatous NEC (K75.3)
reactive nonspecific (K75.2)
viral (B15-B19)

Excluded:

alcoholic fibrosis of the liver (K70.2)
cardial sclerosis of the liver (K76.1)
cirrhosis of the liver):
- alcoholic (K70.3)
- congenital (P78.3)
with toxic liver damage (K71.7)

Excluded:

alcoholic liver disease (K70.-)
amyloid degeneration of the liver (E85.-)
cystic liver disease (congenital) (Q44.6)
hepatic vein thrombosis (I82.0)
hepatomegaly NOS (R16.0)
portal vein thrombosis (I81)
liver toxicity (K71.-)

In Russia, the International Classification of Diseases of the 10th revision (ICD-10) is adopted as a single regulatory document for accounting for morbidity, reasons for the population to apply to medical institutions of all departments, and causes of death.

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. №170

The publication of a new revision (ICD-11) is planned by WHO in 2017 2018.

With amendments and additions by WHO.

Processing and translation of changes © mkb-10.com

Source: http://mkb-10.com/index.php?pid=10331

Causes and treatment of fatty liver

The current pace of life entails an acute shortage of time. People snack on the go from time to time, do not devote time to a normal diet, not to mention playing sports. In response, the body periodically fails - one of the failures is fatty liver hepatosis.

Causes General characteristics of the disease

Hepatosis is a pathological deviation, formed as a result of metabolic disorders and the destruction of liver cells (hepatocytes).

In the International Classifier, each liver disease has its own code. In this case, according to microbial-10 hepatosis, the code K76.0 was assigned.

There are several factors contributing to the development of pathology. In most cases, non-alcoholic fatty liver disease (NAFLD) develops due to dietary preferences - excessive consumption of fatty foods and simple carbohydrates. To this is added a sedentary lifestyle - sedentary work, travel by transport. There is alcoholic hepatosis - the pathology develops as a result of alcoholism. There are also hereditary hepatoses. Secondary hepatosis - develops against the background of other ailments.

Causes of fatty hepatosis of the liver

Alcohol abuse. In most (up to 80% of cases) the disease affects citizens, whose day rarely goes without alcohol. For this reason, fatty hepatosis often occurs in men. Hepatosis develops in women against the background of alcoholism, the symptoms of which are hidden under alcohol intoxication. Fatty liver disease in this case is severe. It is difficult to cure fatty hepatosis of the liver against the background of alcohol, medications and a complete rejection of alcohol are needed.

Narcotic substances. It implies not only the use of heavy "chemistry", but also ordinary energy drinks and other drinks with the addition of caffeine.

Vegetarianism. Oddly enough, the victims of the disease are adherents of a plant-based diet, which, in their opinion, is the most useful and rich. In some cases, the body in a mode of constant protein deficiency fails.

Starvation. Some people resort to strict fasting in order to quickly lose weight without physical activity. A protective reaction can work in the body, and active accumulation of fat begins.

Medical hepatitis. This risk group includes people regardless of age and gender. The disease develops against the background of taking drugs that have a toxic effect on the liver.

Irrational nutrition. Long intervals between meals, frequent use of convenience foods and dishes from fast food cafes.

Diseases associated with metabolic disorders (in particular, fat metabolism). There are many cases of hepatosis development against the background of type 2 diabetes mellitus. It causes obesity not only in the liver, but also in other internal organs.

Toxic substances - car exhausts, employment in hazardous industries.

Fatty liver and pregnancy

Often, without obvious signs of liver disorder, fatty hepatosis occurs in pregnant women. The main reasons are hormonal changes and increased nutrition. It usually occurs in the third trimester, but there are exceptions. With fatty liver hepatosis, complications and even death of a woman during childbirth occur. Often accompanied by jaundice.

nausea;
vomit;
general weakness;
pain and discomfort in the liver;
heartburn that does not go away with a change in diet.

Symptoms should not be attributed to pregnancy and overeating. It is better to immediately report everything to the doctor for an additional examination.

Acute fatty hepatosis (toxic dystrophy)

It develops due to the active effects of toxins on the liver. The reasons are alcohol poisoning, medications in large doses, poisonous mushrooms. Unlike chronic form liver diseases, acute hepatosis develops rapidly.

Chronic hepatosis of the liver

The chronic form (hepatic steatosis) is caused by the effects of alcohol and certain diseases. Cell dystrophy can be defeated with multivitamins and hepatoprotectors.

There are degrees of hepatosis:

initial (zero) - small fat drops are formed in individual liver cells. The stage is non-critical, treated with diet and exercise;
Grade 1 - accumulations of large fat droplets are noticeable, fatty liver begins. Treatment is possible with medications and exercise;
2 degrees - the area of obesity is growing, but treatment and recovery is still possible;
3 degrees - fatty cysts are formed. Lipocytes are actively connected with the connective tissue. An organ transplant is required. It depends on its outcome whether hepatosis of the liver can be cured at this stage. Irreversible processes begin, leading to death. The enlarged organ is easily felt on palpation.

signs

Symptoms of fatty hepatosis of the liver for a long time proceed in a latent form. Hepatosis 1 degree can be seen with the help of ultrasound.

The liver is a unique organ that lacks nerve endings. Therefore, many pathologies in the initial stages are completely asymptomatic.

In the first two stages, fatigue and general weakness appear. The patient may periodically feel discomfort in the right hypochondrium. Without taking medical measures, the second stage comes, and with it frequent bloating, heaviness after eating, heartburn. The liver can increase by 3-5 cm, which becomes noticeable during the examination. In the third stage, the patient is worried about constant nausea, pain in the stomach and right hypochondrium, frequent flatulence. Digestion is disturbed, frequent constipation or diarrhea appear.

Diagnostics

Hepatosis is treated by a gastroenterologist, an endocrinologist and a hepatologist. They find pathologies in the liver and deal with their further treatment. The first step is to rule out other liver diseases. For this, a blood, feces and urine test for bile pigments is given. The following is a list of diagnoses for which a liver examination will not be superfluous:

hyperinsulinemia;
violation of homeostasis;
hypothyroidism;
visceral abdominal obesity.

Timely diagnosis is the key to successful treatment of any disease. Various diagnostic methods identify the problem at all stages.

First, the doctor resorts to the primary examination of the patient. Palpation of the abdomen, right hypochondrium is performed. Hepatomegaly will be detected immediately.

In addition, the doctor may prescribe additional studies:

Ultrasound of the liver and gallbladder is effective in the initial stages of the disease, it determines the structural and morphological changes in the liver;
computed tomography - allows you to determine the increase in the body;
magnetic resonance therapy - will help determine the affected areas and the stage of the disease;
liver biopsy - taking a sample of liver tissue for the detection of lipocytes, helps to finally confirm the diagnosis;
blood test for biochemistry.

Treatment

Before starting treatment, you need to radically change your lifestyle. It is impossible to cure fatty hepatosis of the liver without changing the diet. No medicines will bring the expected result without a special diet. The basis of the diet is to control the fat in the diet. The minimum consumption of fat is due to the fact that the body must actively get rid of the fat accumulated in the liver. With the initial accumulation of lipocytes, triglycerides are easily excreted.

For patients, the doctor prescribes a treatment table No5. This is a complex of therapeutic nutrition aimed at stabilizing the patient's condition. All food is boiled or stewed. Fried foods with fatty liver hepatosis are strictly prohibited. It is a complex of a balanced amount of proteins and carbohydrates. Restriction only in the use of fats. Foods high in cholesterol, oxalic acid, seasonings and spices are also excluded.

vegetables, especially pumpkin, beets, carrots, all varieties of cabbage;
vegetable soups;
milk porridges and soups;
low-fat varieties of cheese;
buckwheat, rice, oatmeal on the water;
low-fat omelette (without the addition of spices, smoked meats, meat products);
boiled eggs;
milk;
kefir, fermented baked milk, curdled milk;
skim cheese.

first courses in meat broth;
fatty meat (lamb, pork, beef, duck);
oily fish;
tomatoes and tomato sauces;
radish;
mushrooms;
garlic;
white bread and rich pastries;
confectionery;
alcoholic drinks;
sausages, sausages, ham;
mayonnaise, ketchup and other sauces;
canned food;
pickles and marinades;
margarine and full fat butter
smoked meats;
fatty dairy products;
soda and packaged juices;
ice cream.

You need to eat fractionally in small portions. Drink more water, preferably at least 2 liters. From hot drinks, freshly brewed weak tea is allowed. Completely exclude coffee, cocoa, strong tea.

It should be remembered that with a neglected state of hepatosis, diet is only part of the treatment. The second component of treatment is medications. Are divided into:

hepatoprotectors;
herbal tablets;
sulfaamino acids.

Folk methods (addition to drug treatment, do not solve the problem on their own):

rosehip infusion - brew fruits, leave for several hours and drink a glass three times a day;
drink tea with mint;
drink fresh carrot juice every day;
drink freshly brewed green tea with lemon more often;
consume daily 50 grams of dried fruits (dried apricots, raisins, prunes).

To get rid of excess fat, you need not only to limit its intake into the body from the outside, but also to burn reserves. You need to devote minutes to exercise every day. Hiking in the fresh air will not be superfluous. A great addition is the refusal to use the elevator.

Possible Complications

In case of untimely detection of the disease or non-compliance with all the rules of treatment, hepatosis turns into cirrhosis, chronic hepatitis and liver failure. The above pathologies are difficult to treat and often lead to death.

Forecast

With early detection, the disease is completely curable. With the right selection of medicines and a sparing diet, the patient's condition improves after 4-6 weeks. Full recovery of the liver occurs in a few months. After completing the course of treatment, patients live a full life - work, play sports, travel, give birth to children. Enough to stick to the basics proper nutrition, do not abuse alcohol, move more - recurrence of the disease is excluded.

If hepatosis is detected at the last stage, treatment is long and difficult. If the disease has turned into cirrhosis or chronic liver failure, treatment is ineffective, 90% of cases are fatal.

Prevention

In general, the prevention of hepatosis includes a set of simple measures. Enough:

eat right up to 5 times a day. The intervals between meals should not exceed 3-4 hours;
the diet should be dominated by fruits, vegetables, herbs, low-fat dairy products;
limit fried, smoked, fatty, salty foods to a minimum, it is better to try to exclude them altogether;
do not forget about physical exercises;
be attentive to taking medications - take them as directed by a doctor after carefully reading the rules for taking them;
reduce alcohol consumption to a minimum.

In order not to worry about whether fatty hepatosis can be cured, you need to regularly undergo preventive examinations and take tests. If you experience unpleasant symptoms associated with the gastrointestinal tract, it is better to consult a doctor and start timely treatment. Timely initiated therapy can cure fatty hepatosis of the liver. An early diagnosis is the key to a successful recovery.

Source: http://pechen.org/gepatoz/zhirovoj.html

Fatty liver (K76.0)

Version: Directory of Diseases MedElement

general information

Short description

Fatty degeneration of the liver is a disease characterized by liver damage with changes similar to changes in alcoholic liver disease (fatty degeneration of hepatocytes hepatocyte is the main liver cell: a large cell that performs various metabolic functions, including the synthesis and accumulation of various substances necessary for the body, neutralization of toxic substances and the formation of bile (Hepatocyte)

), however, with fatty degeneration of the liver, patients do not drink alcohol in quantities that can cause liver damage.

Definitions most commonly used in NAFLD:

1. Non-alcoholic fatty liver disease (NAFL). The presence of fatty degeneration of the liver without signs of damage to hepatocytes hepatocyte - the main cell of the liver: a large cell that performs various metabolic functions, including the synthesis and accumulation of various substances necessary for the body, the neutralization of toxic substances and the formation of bile (Hepatocyte)

in the form of balloon dystrophy or without signs of fibrosis. The risk of developing cirrhosis and liver failure is minimal.

2. Non-alcoholic steatohepatitis (NASH). The presence of liver steatosis and inflammation with damage to hepatocytes hepatocyte - the main cell of the liver: a large cell that performs various metabolic functions, including the synthesis and accumulation of various substances necessary for the body, the neutralization of toxic substances and the formation of bile (Hepatocyte)

(balloon dystrophy) with or without signs of fibrosis. May progress to cirrhosis, liver failure, and (rarely) liver cancer.

3. Non-alcoholic cirrhosis of the liver (NASH Cirrhosis). Presence of evidence of cirrhosis with current or previous histological evidence of steatosis or steatohepatitis.

4. Cryptogenic cirrhosis (Cryptogenic Cirrhosis) - cirrhosis without obvious etiological causes. Patients with cryptogenic cirrhosis usually have high risk factors associated with metabolic disorders such as obesity and metabolic syndrome. Increasingly, cryptogenic cirrhosis, when examined in detail, turns out to be an alcohol-associated disease.

5. Assessment of NAFLD activity (NAS). The totality of points calculated in the complex assessment of the signs of steatosis, inflammation and balloon degeneration. It is a useful tool for the semi-quantitative measurement of histological changes in liver tissue in patients with NAFLD in clinical trials.

K75.81 - Non-alcoholic steatohepatitis (NASH)

K74.0 - Fibrosis of the liver

K74.6 - Other and unspecified cirrhosis of the liver.

Classification

Types of fatty liver degeneration:

1. Macrovesicular type. The accumulation of fat in hepatocytes is local in nature and the nucleus of the hepatocyte shifts away from the center. With fatty infiltration of the liver of the macrovesicular (large-drop) type, triglycerides, as a rule, act as accumulated lipids. At the same time, the morphological criterion of fatty hepatosis is the content of triglycerides in the liver over 10% of the dry mass.

2. Microvesicular type. The accumulation of fat occurs evenly and the core remains in place. In microvesicular (fine) fatty degeneration, other (non-triglycerides) lipids (eg, free fatty acids) accumulate.

There are also focal and diffuse hepatic steatosis. The most common diffuse steatosis, which is zonal in nature (the second and third zone of the lobule).

Etiology and pathogenesis

Primary non-alcoholic fatty disease is considered as one of the manifestations of the metabolic syndrome.

Hyperinsulinism leads to activation of the synthesis of free fatty acids and triglycerides, a decrease in the rate of beta-oxidation of fatty acids in the liver and the secretion of lipids into the bloodstream. As a result, fatty degeneration of hepatocytes develops hepatocyte - the main cell of the liver: a large cell that performs various metabolic functions, including the synthesis and accumulation of various substances necessary for the body, the neutralization of toxic substances and the formation of bile (Hepatocyte)

The occurrence of inflammatory processes is predominantly centrilobular in nature and is associated with increased lipid peroxidation.

Of particular importance is the increased absorption of toxins from the intestines.

A sharp decrease in body weight;

Chronic protein-energy deficiency.

Inflammatory bowel disease;

Celiac Disease Celiac disease is a chronic disease caused by a lack of enzymes involved in the digestion of gluten.

Diverticulosis of the small intestine;

Microbial contamination Contamination is the entry into a certain environment of any impurity that changes the properties of this environment.

Operations on the gastrointestinal tract.

Diabetes mellitus type II;

triglyceridemia, etc.

Epidemiology

Prevalence sign: Common

Sex ratio (m/f): 0.8

The prevalence is estimated to be between 1% and 25% of the general population in various countries. In developed countries, the average level is 2-9%. Many findings are incidentally discovered during liver biopsy performed for other indications.

Most often, the disease is detected at age, although no age (except for breastfed children) excludes the diagnosis.

The sex ratio is unknown, but a female predominance is assumed.

Factors and risk groups

The high risk group includes:

more than 30% of cases is associated with the development of hepatic steatosis Hepatic steatosis is the most common hepatosis, in which fat accumulates in the liver cells

and in 20-47% with non-alcoholic steatohepatosis.

2. Persons with type 2 diabetes mellitus or impaired glucose tolerance. In 60% of patients, these conditions occur in combination with fatty degeneration, in 15% - with non-alcoholic steatohepatitis. The severity of liver damage is related to the severity of impaired glucose metabolism.

3. Persons diagnosed with hyperlipidemia, which is detected in 20-80% of patients with non-alcoholic steatohepatitis. A characteristic fact is the more frequent combination of non-alcoholic steatohepatitis with hypertriglyceridemia than with hypercholesterolemia.

4. Women of middle age.

and uncontrolled blood pressure. There is a higher prevalence of fatty liver in hypertensive patients without risk factors for developing fatty liver. The prevalence of the disease is estimated to be almost 3 times higher than in control groups matched by age and sex and keeping blood pressure at the recommended level.

Malabsorption syndrome Malabsorption syndrome (malabsorption) - a combination of hypovitaminosis, anemia and hypoproteinemia, caused by malabsorption in the small intestine

(as a consequence of the imposition of the ileojejunal Ileojejunal - relating to the ileum and jejunum.

anastomosis, extended resection of the small intestine, gastroplasty for obesity, etc.);

and some others.

Clinical picture

Clinical Criteria for Diagnosis

Symptoms, course

Most patients with non-alcoholic fatty liver disease have no complaints.

Minor discomfort in the upper right quadrant of the abdomen (about 50%);

Pain in the upper right quadrant of the abdomen (30%);

Moderate hepatosplenomegaly Hepatosplenomegaly - simultaneous significant enlargement of the liver and spleen

Arterial hypertension AH ( arterial hypertension, hypertension) - persistent increase in blood pressure from 140/90 mm Hg. and higher.

Dyslipidemia Dyslipidemia is a metabolic disorder of cholesterol and other lipids (fats), which consists in a change in their ratio in the blood

Impaired glucose tolerance.

The appearance of telangiectasia Telangiectasia is a local excessive expansion of capillaries and small vessels.

Palmar erythema Erythema - limited hyperemia (increased blood supply) of the skin

Ascites Ascites - accumulation of transudate in the abdominal cavity

Jaundice, gynecomastia Gynecomastia - an increase in the mammary glands in men

Signs of liver failure and other signs of fibrosis, cirrhosis, non-infectious hepatitis require coding in the appropriate subheadings.

Identified association with alcohol, medication, pregnancy and other etiological causes also requires coding in other subcategories.

Diagnostics

Laboratory diagnostics

are detected in 50-90% of patients, but the absence of these signs does not exclude the presence of non-alcoholic steatohepatitis (NASH).

The level of serum transaminases increased slightly - 2-4 times.

The value of the AST/ALT ratio in NASH:

Less than 1 - observed in the initial stages of the disease (for comparison, in acute alcoholic hepatitis, this ratio is usually > 2);

Equal to 1 or more - may be an indicator of more pronounced liver fibrosis;

More than 2 - is considered as an unfavorable prognostic sign.

2. In 30-60% of patients, an increase in the activity of alkaline phosphatase (usually no more than twofold) and gamma-glutamyl transpeptidase (may be isolated, not associated with an increase in alkaline phosphatase) is detected. A GGTP level > 96.5 U/L increases the risk of fibrosis.

3. In 12-17% of cases, hyperbilirubinemia occurs within% of the norm.

In clinical practice, insulin resistance is measured by the ratio of immunoreactive insulin and blood glucose levels. It should be remembered that this is a calculated indicator, which is calculated by various methods. The indicator is influenced by the level of triglycerides in the blood and race.

7. Hypertriglyceridemia occurs in 20-80% of patients with NASH.

Many patients will have low level HDL as part of the metabolic syndrome.

As the disease progresses, cholesterol levels often decrease.

It should be kept in mind that a low positive antinuclear antibody titer is not uncommon in NASH, and less than 5% of patients may have a positive low titer of antibodies to smooth muscle.

more characteristic of cirrhosis or severe fibrosis.

Unfortunately, this indicator not specific; in case of its increase, it is necessary to exclude a number of oncological diseases ( Bladder, mammary gland, etc.).

11. Comprehensive biochemical tests (BioPredictive, France):

Steato-test - allows you to identify the presence and degree of liver steatosis;

Nash test - allows you to identify NASH in patients with overweight, insulin resistance, hyperlipidemia, as well as patients with diabetes mellitus).

It is possible to use other tests for suspected non-alcoholic fibrosis or hepatitis - Fibro-test and Akti-test.

Differential Diagnosis

Complications

Fibrosis Fibrosis is an overgrowth of fibrous connective tissue that occurs, for example, as a result of inflammation.

Cirrhosis of the liver Cirrhosis of the liver is a chronic progressive disease characterized by dystrophy and necrosis of the hepatic parenchyma, accompanied by its nodular regeneration, diffuse proliferation of connective tissue and a deep restructuring of the liver architectonics.

In detail (develops especially rapidly in patients with tyrosinemia Tyrosinemia is an increased concentration of tyrosine in the blood. The disease leads to increased urinary excretion of tyrosine compounds, hepatosplenomegaly, nodular cirrhosis of the liver, multiple defects in renal tubular reabsorption and vitamin D resistant rickets. Tyrosinemia and tyrosyl excretion occur when a number of inherited (p) fermentopathies: fumarylacetoacetase deficiencies (type I), tyrosine aminotransferase (type II), 4-hydroxyphenylpyruvate hydroxylase (type III)

Almost bypassing the stage of "pure" fibrosis);

Liver failure (rarely - in parallel with the rapid formation of cirrhosis).

Treatment

Forecast

Life expectancy in non-alcoholic fatty liver disease is not lower than in healthy individuals.

Half of the patients develop progressive fibrosis, and 1/6 - cirrhosis of the liver.

Hospitalization

Prevention

1. Normalization of body weight.

2. Patients should be screened for hepatitis viruses. In the absence of viral hepatitis, they should be offered vaccination against hepatitis B and A.

Source: http://diseases.medelement.com/disease/%D0%B6%D0%B8%D1%80%D0%BE%D0%B2%D0%B0%D1%8F-%D0%B4%D0% B5%D0%B3%D0%B5%D0%BD%D0%B5%D1%80%D0%B0%D1%86%D0%B8%D1%8F-%D0%BF%D0%B5%D1%87 %D0%B5%D0%BD%D0%B8-k76-0/4827

Fatty liver disease

Description of the disease

Fatty hepatosis of the liver (liver steatosis, fatty degeneration of the liver, fatty liver) is a chronic liver disease characterized by fatty degeneration of liver cells. It occurs quite often, develops under the influence of alcohol, toxic substances (medicines), diabetes mellitus, anemia, lung diseases, severe pancreatitis and enteritis, malnutrition, obesity.

The reasons

According to the mechanism of development, hepatosis occurs due to excessive intake of fats in the liver, overload of the liver with dietary fats and carbohydrates, or due to impaired excretion of fats from the liver. Violation of the excretion of fat from the liver occurs with a decrease in the amount of substances involved in the processing of fats (protein, lipotropic factors). The formation of phospholipids, beta-lipoproteins, lecithin from fats is disrupted. And excess free fats are deposited in the liver cells.

Symptoms

Patients with hepatosis usually do not complain. The course of the disease is blurred, slowly progressing. Over time, there are constant dull pains in the right hypochondrium, nausea, vomiting, stool disorders. The patient is concerned about weakness, headache, dizziness, fatigue during exercise. Very rarely, hepatosis is observed with a pronounced clinical picture: severe pain, weight loss, itching, bloating. On examination, an enlarged, slightly painful liver is found. The course of the disease is usually not severe, but sometimes fatty hepatosis can turn into chronic hepatitis or cirrhosis of the liver.

Diagnostics

With ultrasound of the abdominal cavity - an increase in the echogenicity of the liver, an increase in its size. AT biochemical research blood, a slight increase in the activity of liver tests and changes in protein fractions.

Treatment

First of all, one should either eliminate or minimize the effect of the factor that led to the deposition of fat in the liver. This is almost always possible in relation to alcohol, if it is not about the formation of dependence, when the help of a narcologist is required. Patients with diabetes mellitus and hyperlipidemia should be observed jointly by an endocrinologist and a cardiologist, respectively. All patients require a low-fat diet and sufficient daily physical activity.

In obese patients, doctors usually consider it necessary to reduce the patient's body weight. The effect of weight loss on the course of fatty hepatosis is ambiguous. Rapid weight loss naturally leads to an increase in inflammation activity and progression of fibrosis. Reducing the weight nakg/year positively affects the severity of steatosis, inflammation and the degree of liver fibrosis. The most effective weight loss is considered to be no more than 1.6 kg / week, which is achieved with a daily caloric intake of 25 cal / kg / day.

Fatty hepatosis of the liver in the ICD classification:

Hello! Which doctor should I contact for treatment for a diagnosis of cirrhosis of the liver?

Which doctors should I contact if fatty hepatosis of the liver occurs:

Good afternoon. I am 67 years old, height 158 cm, weight 78 kg. I started gaining weight after the death of my husband. I do not abuse alcohol. I walk moderately. What should I do? The analyzes are normal - and the ultrasound diagnosis: echo-signs of fatty hepatosis, chronic cholecystitis, chronic pancreatitis. What to do?

Source: http://med36.com/ill/428

Fatty hepatosis

Liver problems have always been a big concern for many people. Indeed, if this important organ is out of order, then you can forget about the normal functioning of the whole organism. Yes, and the activity of the person himself turns out to be practically stopped until he begins the correct treatment of his illness.

Many believe that liver problems are the result of a poor lifestyle or alcohol abuse. Often this is true, but there are still other reasons that affect the appearance of liver diseases. Diseases such as fatty liver can also occur due to completely different factors, which we will talk about.

What is fatty liver disease?

Under fatty hepatosis (another name is non-alcoholic steatohepatitis) is understood a certain process, as a result of which a fatty layer begins to form in the liver cells. Moreover, there is a picture when fat cells begin to completely replace healthy liver cells, which is a consequence of the accumulation of simple fats in healthy cells of the organ.

According to the ICD-10, fatty liver disease has the code K 76 and the name "fatty liver degeneration".

The liver performs the function of processing various toxins that are formed as a result of the use of alcoholic beverages and medicines. The body converts all these components into simple fats, but any person is already prone to eating fatty foods, so there is an excess of fat in the liver cells. It is at this moment that the accumulation of fat cells in the liver occurs, which leads to the appearance of the disease.

Ignoring the treatment process, fat cells begin to accumulate, forming a full-fledged adipose tissue on the surface of the liver. Naturally, such a layer of fat prevents the body from performing its protective functions, leaving the body alone with various harmful toxins and similar substances.

The danger of such a disease as fatty hepatosis lies in the possibility of developing into more serious diseases - fibrosis and cirrhosis of the liver, and this is an immediate threat to human life.

To avoid this, it is necessary to diagnose the disease in a timely manner. At the first signs of the disease, you should contact the specialized specialists - an endocrinologist or a hepatologist. At the same time, the endocrinologist is responsible for treating the causes that led to the appearance of the disease, and the hepatologist treats the liver damage itself directly.

The reasons

For the correct preparation of the treatment regimen, it is necessary to find out which cause was the result of the occurrence of fatty hepatosis. Below are the most likely factors that directly affect the formation of fat cells, as well as their replacement of healthy ones:

If a person is diagnosed with diseases in which fat metabolism is impaired. These include obesity, type 2 diabetes, and if a person has an elevated level of lipids in the blood.
The effect of toxins on the body. The liver copes well with various kinds of toxins that enter the body along with certain foods and alcohol, but if this exposure is regular and intense, then the organ simply ceases to cope with the load. In particular, if a person regularly consumes alcohol, then he may develop alcoholic fatty hepatosis.
If settlements are located near radioactive waste disposal sites, then there is a high risk of fatty liver among its inhabitants.
Wrong food intake. If a person eats irregularly, there is not enough protein in his diet, then this disrupts the process of lipid metabolism. In addition, lovers of a beautiful figure who exhaust themselves with strict diets and starvation can also be included here. As a result of these actions, the body is depleted, which leads to the appearance of the disease.
Wrong work digestive system can also be a consequence of the appearance of fatty hepatosis.
Antibiotics solve many problems, but they can also harm. Especially if the course of treatment is long, and at the end of it, restorative therapy in the form of taking probiotics was not carried out.
Various endocrine diseases, which are expressed in the lack of thyroxin - a hormone thyroid gland, or excessive influence of cortisol, aldosterone and other hormones of the adrenal cortex.
Of particular danger is fatty hepatosis during pregnancy, because there is a real risk to the fetus. At the same time, hepatosis is considered a disease of a hereditary nature, so it can be transmitted from mother to her child.

Under the hour of pregnancy in the body of a woman, an increased formation of estrogens is observed, which leads to the occurrence of cholestasis. Hepatosis itself begins to develop against the background of active bile secretion into the blood. Experts note that fatty hepatosis occurs in those women who have previously suffered from any liver disease.

Varieties of the disease

The types of the disease differ in the degree of accumulation of fat cells. To date, there are several stages:

On the organ there is a single or multiple accumulation of fat cells. Against their background, diffuse fatty hepatosis may develop.

Second degree

With this form, the area of fat accumulations increases, and connective tissue begins to form between the cells.

Third degree

On the organ, connective tissue is already pronounced, which ends with fibroblasts. There is also a large accumulation of fat on the liver.

Symptoms

Fatty hepatosis does not manifest itself immediately, so it is quite difficult to diagnose it at an early stage. It takes a certain amount of time before fat cells begin to take out healthy liver cells. Symptoms are most pronounced in the third degree, but it is better not to bring it up to this point, because in this case only a transplant of a healthy organ will help.

Here is a list of the main symptoms:

vomit;
gagging;
blurred vision;
dysbacteriosis;
in the area of the liver, a person begins to feel a feeling of heaviness;
dull skin tone.

The insidiousness of this disease lies in the fact that these symptoms are not very pronounced, so a person quite often ignores them, believing that he just ate something wrong. Therefore, doctors advise not to be negligent to your health, but to contact specialists even with minor complaints and symptoms.

Diagnostics

If a patient goes to a specialist with the above symptoms, then the doctor should prescribe one of the following examinations:

Ultrasound examination, which should show echoes of the disease.

As a rule, ultrasound is enough for the timely diagnosis of fatty hepatosis. Even minor diffuse changes in the liver can be a cause for concern. To identify them, the following diagnostics are carried out:

Clinical and biochemical analysis of blood.
Echography.
Analysis of urine.
Ultrasound procedure.

medical treatment

The treatment of fatty hepatosis is a combination of many actions, among many of which, as a technique medical preparations, as well as a certain diet aimed at abandoning negative habits.

Now Lopid, Troglitatazone and Actigall are used as medicines for this disease. In principle, all therapy should be based on the following factors:

Taking medications that normalize blood circulation.
Insulin medications.
Lipid balancing drugs.
Proper nutrition.

In this video you will see clearly what happens to the liver during illness and how to cope with the disease.

Treatment at home

But apart from traditional medicine, there is also a folk one, which also turns out to be very effective in the treatment of fatty hepatosis. Many experts point out that it is the treatment folk remedies allows you to get rid of this disease. The essence of this treatment is to take various decoctions that cleanse the liver.

Here are some actionable recipes.

If a person has an enlarged liver against the background of fatty hepatosis, then you can try the following recipe:

We take a few lemons, which we previously washed.
We grind them together with the peel in a blender, or pass through a meat grinder.
We take half a liter of boiling water and pour the resulting slurry of lemons, then leave it overnight.
The next day, it is necessary to strain the broth, and then take it during the day immediately before meals.
Remember that you can drink the infusion only three days in a row.

In this video, even more recipes and methods of dealing with the disease.

Diet

Fatty hepatosis is a specific disease, which can be eliminated only if a person completely changes his lifestyle. We have already talked about giving up alcohol, but we will also have to normalize nutrition by following the right diet. Its basis is to minimize the amount of fat entering the body, so the steaming or boiling method should be used for cooking.

fatty meat broths;
meat and fish containing a large amount of fat;
garlic and onions;
legumes;
mushrooms;
tomatoes;
various kinds of canned products;
radish;
fatty sour cream and also cottage cheese;
smoked meats and pickles;
all carbonated drinks, coffee and cocoa should be deleted from the menu. You can replace them with green tea without sugar.

As for allowed products, there are also several of them:

vegetables in any form, except stewed and fried;
milk soup;
soups and broths without meat;
low-fat cheese;
steamed omelet;
one boiled egg per day.
dairy products with low fat content;
various kinds of cereals from rice, oats, buckwheat, semolina, etc.;
you need to include any greens in the diet: parsley, dill, etc. They help to remove excess fats from the body, and they are very effective for preventive purposes;
you still need to eat the following foods: rice bran, apricot pits, watermelon, pumpkin, brewer's yeast, etc.
you should also include dried fruits in your daily diet: about 25 grams per day.

Attention! You must understand that taking medications alone will not give the desired result. Only complex therapy based on a strict diet will help remove accumulated toxins and fats from the body.

Watch this video for preventive measures.

Fatty liver disease is not a disease that cannot be cured. If you do not run it to the extreme stage, when only a liver transplant can help, then you can get rid of this problem with the usual folk remedies and the right diet. Of course, you will have to give up the usual dishes and pleasures, but when the question of health arises, then other moments should be put on the back burner.

At the initial stage of development, fat accumulates in hepatocytes, which over time simply leads to dystrophy of the liver cells.

Causes of fatty liver and its prevalence

The causes of the development of the disease have not yet been exactly proven, but factors are known that can surely provoke the onset of this disease. These include:

completeness;
diabetes;
violation of metabolic processes (lipid);
minimal physical activity with a nutritious daily diet high in fat.

Most cases of development of fatty hepatosis are recorded by physicians in developed countries with above-average living standards.

In medicine, it is very convenient to use the coding of diseases to systematize them. It is even easier to indicate a diagnosis on a sick leave using a code. Codes for all diseases are presented in the International Classification of Diseases, Injuries and Various Health Problems. The tenth revision is currently in effect.

You can learn more about the symptoms, diagnosis and treatment of hepatosis from separate materials:

Treatment of fatty liver

LIVER DISEASES (K70-K77)

Included: medicinal:

idiosyncratic (unpredictable) liver disease
toxic (predictable) liver disease

Use an additional external cause code (class XX) if necessary to identify the toxic substance.

Excluded:

Budd-Chiari syndrome (I82.0)

Included:

hepatic:
- coma NOS
- encephalopathy NOS
hepatitis:
- fulminant, not elsewhere classified, with liver failure
- malignant, not elsewhere classified, with liver failure
liver (cell) necrosis with liver failure
yellow atrophy or liver dystrophy

Excluded:

alcoholic liver failure (K70.4)
liver failure complicating:
- abortion, ectopic or molar pregnancy (O00-O07, O08.8)
- pregnancy, childbirth and the puerperium (O26.6)
fetal and neonatal jaundice (P55-P59)
viral hepatitis (B15-B19)
associated with toxic liver damage (K71.1)

Excludes: hepatitis (chronic):

alcoholic (K70.1)
medicinal (K71.-)
granulomatous NEC (K75.3)
reactive nonspecific (K75.2)
viral (B15-B19)

Excluded:

alcoholic fibrosis of the liver (K70.2)
cardial sclerosis of the liver (K76.1)
cirrhosis of the liver):
- alcoholic (K70.3)
- congenital (P78.3)
with toxic liver damage (K71.7)

Excluded:

alcoholic liver disease (K70.-)
amyloid degeneration of the liver (E85.-)
cystic liver disease (congenital) (Q44.6)
hepatic vein thrombosis (I82.0)
hepatomegaly NOS (R16.0)
portal vein thrombosis (I81)
liver toxicity (K71.-)

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. №170

The publication of a new revision (ICD-11) is planned by WHO in 2017 2018.

With amendments and additions by WHO.

Processing and translation of changes © mkb-10.com

Causes and treatment of fatty liver

Causes General characteristics of the disease

Hepatosis is a pathological deviation, formed as a result of metabolic disorders and the destruction of liver cells (hepatocytes).

In the International Classifier, each liver disease has its own code. In this case, according to microbial-10 hepatosis, the code K76.0 was assigned.

Causes of fatty hepatosis of the liver

Narcotic substances. It implies not only the use of heavy "chemistry", but also ordinary energy drinks and other drinks with the addition of caffeine.

Starvation. Some people resort to strict fasting in order to quickly lose weight without physical activity. A protective reaction can work in the body, and active accumulation of fat begins.

Medical hepatitis. This risk group includes people regardless of age and gender. The disease develops against the background of taking drugs that have a toxic effect on the liver.

Irrational nutrition. Long intervals between meals, frequent use of convenience foods and dishes from fast food cafes.

Toxic substances - car exhausts, employment in hazardous industries.

Fatty liver and pregnancy

nausea;
vomit;
general weakness;
pain and discomfort in the liver;
heartburn that does not go away with a change in diet.

Symptoms should not be attributed to pregnancy and overeating. It is better to immediately report everything to the doctor for an additional examination.

Acute fatty hepatosis (toxic dystrophy)

It develops due to the active effects of toxins on the liver. The reasons are alcohol poisoning, medications in large doses, poisonous mushrooms. Unlike the chronic form of liver disease, acute hepatosis develops rapidly.

Chronic hepatosis of the liver

The chronic form (hepatic steatosis) is caused by the effects of alcohol and certain diseases. Cell dystrophy can be defeated with multivitamins and hepatoprotectors.

There are degrees of hepatosis:

initial (zero) - small fat drops are formed in individual liver cells. The stage is non-critical, treated with diet and exercise;
Grade 1 - accumulations of large fat droplets are noticeable, fatty liver begins. Treatment is possible with medications and exercise;
2 degrees - the area of obesity is growing, but treatment and recovery is still possible;
3 degrees - fatty cysts are formed. Lipocytes are actively connected with the connective tissue. An organ transplant is required. It depends on its outcome whether hepatosis of the liver can be cured at this stage. Irreversible processes begin, leading to death. The enlarged organ is easily felt on palpation.

signs

Symptoms of fatty hepatosis of the liver for a long time proceed in a latent form. Hepatosis 1 degree can be seen with the help of ultrasound.

The liver is a unique organ that lacks nerve endings. Therefore, many pathologies in the initial stages are completely asymptomatic.

Diagnostics

hyperinsulinemia;
violation of homeostasis;
hypothyroidism;
visceral abdominal obesity.

Timely diagnosis is the key to successful treatment of any disease. Various diagnostic methods identify the problem at all stages.

First, the doctor resorts to the primary examination of the patient. Palpation of the abdomen, right hypochondrium is performed. Hepatomegaly will be detected immediately.

In addition, the doctor may prescribe additional studies:

Ultrasound of the liver and gallbladder is effective in the initial stages of the disease, it determines the structural and morphological changes in the liver;
computed tomography - allows you to determine the increase in the body;
magnetic resonance therapy - will help determine the affected areas and the stage of the disease;
liver biopsy - taking a sample of liver tissue for the detection of lipocytes, helps to finally confirm the diagnosis;
blood test for biochemistry.

Treatment

vegetables, especially pumpkin, beets, carrots, all varieties of cabbage;
vegetable soups;
milk porridges and soups;
low-fat varieties of cheese;
buckwheat, rice, oatmeal on the water;
low-fat omelette (without the addition of spices, smoked meats, meat products);
boiled eggs;
milk;
kefir, fermented baked milk, curdled milk;
skim cheese.

first courses in meat broth;
fatty meat (lamb, pork, beef, duck);
oily fish;
tomatoes and tomato sauces;
radish;
mushrooms;
garlic;
white bread and rich pastries;
confectionery;
alcoholic drinks;
sausages, sausages, ham;
mayonnaise, ketchup and other sauces;
canned food;
pickles and marinades;
margarine and full fat butter
smoked meats;
fatty dairy products;
soda and packaged juices;
ice cream.

You need to eat fractionally in small portions. Drink more water, preferably at least 2 liters. From hot drinks, freshly brewed weak tea is allowed. Completely exclude coffee, cocoa, strong tea.

It should be remembered that with a neglected state of hepatosis, diet is only part of the treatment. The second component of treatment is medications. Are divided into:

hepatoprotectors;
herbal tablets;
sulfaamino acids.

Alternative methods (addition to drug treatment, they do not solve the problem on their own):

rosehip infusion - brew fruits, leave for several hours and drink a glass three times a day;
drink tea with mint;
drink fresh carrot juice every day;
drink freshly brewed green tea with lemon more often;
consume daily 50 grams of dried fruits (dried apricots, raisins, prunes).

Possible Complications

Forecast

With early detection, the disease is completely curable. With the right selection of medicines and a sparing diet, the patient's condition improves after 4-6 weeks. Full recovery of the liver occurs in a few months. After completing the course of treatment, patients live a full life - work, play sports, travel, give birth to children. It is enough to adhere to the basics of proper nutrition, not to abuse alcohol, to move more - a recurrence of the disease is excluded.

If hepatosis is detected at the last stage, treatment is long and difficult. If the disease has turned into cirrhosis or chronic liver failure, treatment is ineffective, 90% of cases are fatal.

Prevention

In general, the prevention of hepatosis includes a set of simple measures. Enough:

eat right up to 5 times a day. The intervals between meals should not exceed 3-4 hours;
the diet should be dominated by fruits, vegetables, herbs, low-fat dairy products;
limit fried, smoked, fatty, salty foods to a minimum, it is better to try to exclude them altogether;
do not forget about physical exercises;
be attentive to taking medications - take them as directed by a doctor after carefully reading the rules for taking them;
reduce alcohol consumption to a minimum.

Fatty liver (K76.0)

Version: Directory of Diseases MedElement

general information

Short description

), however, with fatty degeneration of the liver, patients do not drink alcohol in quantities that can cause liver damage.

Definitions most commonly used in NAFLD:

in the form of balloon dystrophy or without signs of fibrosis. The risk of developing cirrhosis and liver failure is minimal.

(balloon dystrophy) with or without signs of fibrosis. May progress to cirrhosis, liver failure, and (rarely) liver cancer.

3. Non-alcoholic cirrhosis of the liver (NASH Cirrhosis). Presence of evidence of cirrhosis with current or previous histological evidence of steatosis or steatohepatitis.

K75.81 - Non-alcoholic steatohepatitis (NASH)

K74.0 - Fibrosis of the liver

K74.6 - Other and unspecified cirrhosis of the liver.

Classification

Types of fatty liver degeneration:

There are also focal and diffuse hepatic steatosis. The most common diffuse steatosis, which is zonal in nature (the second and third zone of the lobule).

Etiology and pathogenesis

Primary non-alcoholic fatty disease is considered as one of the manifestations of the metabolic syndrome.

The occurrence of inflammatory processes is predominantly centrilobular in nature and is associated with increased lipid peroxidation.

Of particular importance is the increased absorption of toxins from the intestines.

A sharp decrease in body weight;

Chronic protein-energy deficiency.

Inflammatory bowel disease;

Celiac Disease Celiac disease is a chronic disease caused by a lack of enzymes involved in the digestion of gluten.

Diverticulosis of the small intestine;

Microbial contamination Contamination is the entry into a certain environment of any impurity that changes the properties of this environment.

Operations on the gastrointestinal tract.

Diabetes mellitus type II;

triglyceridemia, etc.

Epidemiology

Prevalence sign: Common

Sex ratio (m/f): 0.8

Most often, the disease is detected at age, although no age (except for breastfed children) excludes the diagnosis.

The sex ratio is unknown, but a female predominance is assumed.

Factors and risk groups

The high risk group includes:

more than 30% of cases is associated with the development of hepatic steatosis Hepatic steatosis is the most common hepatosis, in which fat accumulates in the liver cells

and in 20-47% with non-alcoholic steatohepatosis.

4. Women of middle age.

Malabsorption syndrome Malabsorption syndrome (malabsorption) - a combination of hypovitaminosis, anemia and hypoproteinemia, caused by malabsorption in the small intestine

(as a consequence of the imposition of the ileojejunal Ileojejunal - relating to the ileum and jejunum.

anastomosis, extended resection of the small intestine, gastroplasty for obesity, etc.);

and some others.

Clinical picture

Clinical Criteria for Diagnosis

Symptoms, course

Most patients with non-alcoholic fatty liver disease have no complaints.

Minor discomfort in the upper right quadrant of the abdomen (about 50%);

Pain in the upper right quadrant of the abdomen (30%);

Moderate hepatosplenomegaly Hepatosplenomegaly - simultaneous significant enlargement of the liver and spleen

Arterial hypertension AG (arterial hypertension, hypertension) - persistent increase in blood pressure from 140/90 mm Hg. and higher.

Dyslipidemia Dyslipidemia is a metabolic disorder of cholesterol and other lipids (fats), which consists in a change in their ratio in the blood

Impaired glucose tolerance.

The appearance of telangiectasia Telangiectasia is a local excessive expansion of capillaries and small vessels.

Palmar erythema Erythema - limited hyperemia (increased blood supply) of the skin

Ascites Ascites - accumulation of transudate in the abdominal cavity

Jaundice, gynecomastia Gynecomastia - an increase in the mammary glands in men

Signs of liver failure and other signs of fibrosis, cirrhosis, non-infectious hepatitis require coding in the appropriate subheadings.

Identified association with alcohol, medication, pregnancy and other etiological causes also requires coding in other subcategories.

Diagnostics

Laboratory diagnostics

are detected in 50-90% of patients, but the absence of these signs does not exclude the presence of non-alcoholic steatohepatitis (NASH).

The level of serum transaminases increased slightly - 2-4 times.

The value of the AST/ALT ratio in NASH:

Less than 1 - observed in the initial stages of the disease (for comparison, in acute alcoholic hepatitis, this ratio is usually > 2);

Equal to 1 or more - may be an indicator of more pronounced liver fibrosis;

More than 2 - is considered as an unfavorable prognostic sign.

3. In 12-17% of cases, hyperbilirubinemia occurs within% of the norm.

7. Hypertriglyceridemia occurs in 20-80% of patients with NASH.

Many patients will have low HDL as part of the metabolic syndrome.

As the disease progresses, cholesterol levels often decrease.

It should be kept in mind that a low positive antinuclear antibody titer is not uncommon in NASH, and less than 5% of patients may have a positive low titer of antibodies to smooth muscle.

more characteristic of cirrhosis or severe fibrosis.

Unfortunately, this indicator is not specific; in case of its increase, it is necessary to exclude a number of oncological diseases (bladder, breast, etc.).

11. Comprehensive biochemical tests (BioPredictive, France):

Steato-test - allows you to identify the presence and degree of liver steatosis;

Nash test - allows you to identify NASH in patients with overweight, insulin resistance, hyperlipidemia, as well as patients with diabetes mellitus).

It is possible to use other tests for suspected non-alcoholic fibrosis or hepatitis - Fibro-test and Akti-test.

Differential Diagnosis

Complications

Fibrosis Fibrosis is an overgrowth of fibrous connective tissue that occurs, for example, as a result of inflammation.

Practically bypassing the stage of "pure" fibrosis);

Liver failure (rarely - in parallel with the rapid formation of cirrhosis).

Treatment

Forecast

Life expectancy in non-alcoholic fatty liver disease is not lower than in healthy individuals.

Half of the patients develop progressive fibrosis, and 1/6 - cirrhosis of the liver.

Hospitalization

Prevention

1. Normalization of body weight.

2. Patients should be screened for hepatitis viruses. In the absence of viral hepatitis, they should be offered vaccination against hepatitis B and A.

Fatty liver disease

Description of the disease

The reasons

Symptoms

Diagnostics

With ultrasound of the abdominal cavity - an increase in the echogenicity of the liver, an increase in its size. In a biochemical study of blood, a slight increase in the activity of liver tests and changes in protein fractions.

Treatment

Fatty hepatosis of the liver in the ICD classification:

Hello! Which doctor should I contact for treatment for a diagnosis of cirrhosis of the liver?

Which doctors should I contact if fatty hepatosis of the liver occurs:

Fatty hepatosis

What is fatty liver disease?

According to the ICD-10, fatty liver disease has the code K 76 and the name "fatty liver degeneration".

The liver performs the function of processing various toxins that are formed as a result of the use of alcoholic beverages and drugs. The body converts all these components into simple fats, but any person is already prone to eating fatty foods, so there is an excess of fat in the liver cells. It is at this moment that the accumulation of fat cells in the liver occurs, which leads to the appearance of the disease.

The danger of such a disease as fatty hepatosis lies in the possibility of developing into more serious diseases - fibrosis and cirrhosis of the liver, and this is an immediate threat to human life.

The reasons

If a person is diagnosed with diseases in which fat metabolism is impaired. These include obesity, type 2 diabetes, and if a person has an elevated level of lipids in the blood.
The effect of toxins on the body. The liver copes well with various kinds of toxins that enter the body along with certain foods and alcohol, but if this exposure is regular and intense, then the organ simply ceases to cope with the load. In particular, if a person regularly consumes alcohol, then he may develop alcoholic fatty hepatosis.
If settlements are located near radioactive waste disposal sites, then there is a high risk of fatty liver among its inhabitants.
Wrong food intake. If a person eats irregularly, there is not enough protein in his diet, then this disrupts the process of lipid metabolism. In addition, lovers of a beautiful figure who exhaust themselves with strict diets and starvation can also be included here. As a result of these actions, the body is depleted, which leads to the appearance of the disease.
Improper functioning of the digestive system can also be a consequence of the appearance of fatty hepatosis.
Antibiotics solve many problems, but they can also harm. Especially if the course of treatment is long, and at the end of it, restorative therapy in the form of taking probiotics was not carried out.
Various endocrine diseases, which are expressed in a lack of thyroxine - a thyroid hormone, or excessive influence of cortisol, aldosterone and other hormones of the adrenal cortex.
Of particular danger is fatty hepatosis during pregnancy, because there is a real risk to the fetus. At the same time, hepatosis is considered a disease of a hereditary nature, so it can be transmitted from mother to her child.

Varieties of the disease

The types of the disease differ in the degree of accumulation of fat cells. To date, there are several stages:

On the organ there is a single or multiple accumulation of fat cells. Against their background, diffuse fatty hepatosis may develop.

Second degree

With this form, the area of fat accumulations increases, and connective tissue begins to form between the cells.

Third degree

On the organ, connective tissue is already pronounced, which ends with fibroblasts. There is also a large accumulation of fat on the liver.

Symptoms

Here is a list of the main symptoms:

vomit;
gagging;
blurred vision;
dysbacteriosis;
in the area of the liver, a person begins to feel a feeling of heaviness;
dull skin tone.

Diagnostics

If a patient goes to a specialist with the above symptoms, then the doctor should prescribe one of the following examinations:

Ultrasound examination, which should show echoes of the disease.

Clinical and biochemical analysis of blood.
Echography.
Analysis of urine.
Ultrasound procedure.

medical treatment

The treatment of fatty liver is a combination of many actions, among many of which are taking medications, as well as a certain diet aimed at abandoning negative habits.

Now Lopid, Troglitatazone and Actigall are used as medicines for this disease. In principle, all therapy should be based on the following factors:

Taking medications that normalize blood circulation.
Insulin medications.
Lipid balancing drugs.
Proper nutrition.

In this video you will see clearly what happens to the liver during illness and how to cope with the disease.

Treatment at home

But in addition to traditional medicine, there is also folk medicine, which also turns out to be very effective in the treatment of fatty hepatosis. Many experts note that it is the treatment of folk remedies that allows you to get rid of this disease. The essence of this treatment is to take various decoctions that cleanse the liver.

Here are some actionable recipes.

If a person has an enlarged liver against the background of fatty hepatosis, then you can try the following recipe:

We take a few lemons, which we previously washed.
We grind them together with the peel in a blender, or pass through a meat grinder.
We take half a liter of boiling water and pour the resulting slurry of lemons, then leave it overnight.
The next day, it is necessary to strain the broth, and then take it during the day immediately before meals.
Remember that you can drink the infusion only three days in a row.

In this video, even more recipes and methods of dealing with the disease.

Diet

fatty meat broths;
meat and fish containing a large amount of fat;
garlic and onions;
legumes;
mushrooms;
tomatoes;
various kinds of canned products;
radish;
fatty sour cream and also cottage cheese;
smoked meats and pickles;
all carbonated drinks, coffee and cocoa should be deleted from the menu. You can replace them with green tea without sugar.

As for allowed products, there are also several of them:

vegetables in any form, except stewed and fried;
milk soup;
soups and broths without meat;
low-fat cheese;
steamed omelet;
one boiled egg per day.
dairy products with low fat content;
various kinds of cereals from rice, oats, buckwheat, semolina, etc.;
you need to include any greens in the diet: parsley, dill, etc. They help to remove excess fats from the body, and they are very effective for preventive purposes;
you still need to eat the following foods: rice bran, apricot pits, watermelon, pumpkin, brewer's yeast, etc.
you should also include dried fruits in your daily diet: about 25 grams per day.

Attention! You must understand that taking medications alone will not give the desired result. Only complex therapy based on a strict diet will help remove accumulated toxins and fats from the body.

Watch this video for preventive measures.

LIVER DISEASES (K70-K77)

Included: medicinal:

idiosyncratic (unpredictable) liver disease
toxic (predictable) liver disease

Use an additional external cause code (class XX) if necessary to identify the toxic substance.

Excluded:

Budd-Chiari syndrome (I82.0)

Included:

hepatic:
- coma NOS
- encephalopathy NOS
hepatitis:
- fulminant, not elsewhere classified, with liver failure
- malignant, not elsewhere classified, with liver failure
liver (cell) necrosis with liver failure
yellow atrophy or liver dystrophy

Excluded:

alcoholic liver failure (K70.4)
liver failure complicating:
- abortion, ectopic or molar pregnancy (O00-O07, O08.8)
fetal and neonatal jaundice (P55-P59)
viral hepatitis (B15-B19)
associated with toxic liver damage (K71.1)

Excludes: hepatitis (chronic):

alcoholic (K70.1)
medicinal (K71.-)
granulomatous NEC (K75.3)
reactive nonspecific (K75.2)
viral (B15-B19)

Excluded:

alcoholic fibrosis of the liver (K70.2)
cardial sclerosis of the liver (K76.1)
cirrhosis of the liver):
- alcoholic (K70.3)
- congenital (P78.3)
with toxic liver damage (K71.7)

Excluded:

alcoholic liver disease (K70.-)
amyloid degeneration of the liver (E85.-)
cystic liver disease (congenital) (Q44.6)
hepatic vein thrombosis (I82.0)
hepatomegaly NOS (R16.0)
portal vein thrombosis (I81)
liver toxicity (K71.-)

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. №170

The publication of a new revision (ICD-11) is planned by WHO in 2017 2018.

With amendments and additions by WHO.

Processing and translation of changes © mkb-10.com

Source: http://mkb-10.com/index.php?pid=10331

K70-K77 Diseases of the liver. V. 2016

International Classification of Diseases 10th Revision (ICD-10)

K70-K77 Diseases of the liver

Reye's syndrome (G93.7)

viral hepatitis (B15-B19)

K70 Alcoholic liver disease

K71 Liver toxicity

Budd-Chiari syndrome (I82.0)

"Pure" cholestasis K71.1 Toxic liver damage with hepatic necrosis Hepatic failure (acute) (chronic), due to drugs K71.2 Toxic liver damage, proceeding according to the type of acute hepatitis

yellow atrophy or dystrophy of the liver

liver failure complicating:

abortion, ectopic or molar pregnancy (O00-O07, O08.8)
pregnancy, childbirth and the puerperium (O26.6)

fetal and neonatal jaundice (P55-P59)

viral hepatitis (B15-B19)

associated with toxic liver injury (K71.1)

K74 Fibrosis and cirrhosis of the liver

cardial sclerosis of the liver (K76.1)

cirrhosis of the liver:

alcoholic (K70.3)
congenital (P78.3)

with toxic liver damage (K71.7-) K74.0 Liver fibrosis

acute or subacute
- NOS (B17.9)
- not viral (K72.0)
viral hepatitis (B15-B19)

liver toxicity (K71.1)

cholangitis without liver abscess (K83.0)

pylephlebitis without liver abscess (K75.1) K75.1 Phlebitis of the portal vein Pylephlebitis Ruled out: pylephlebitic liver abscess (K75.0)

amyloid degeneration of the liver (E85.-)

cystic liver disease (congenital) (Q44.6)

hepatic vein thrombosis (I82.0)

portal vein thrombosis (I81.-)

liver toxicity (K71.-)

Focal nodular hyperplasia of the liver

Hepatoptosis K76.9 Liver disease, unspecified

Portal hypertension in schistosomiasis B65.- †)

Liver damage in syphilis (A52.7 †) K77.8* Liver damage in other diseases classified elsewhere Hepatic granulomas in:

berylliose (J63.2†)
sarcoidosis (D86.8 †)

Notes. 1. This version corresponds to the 2016 version of the WHO (ICD-10 Version: 2016), some positions of which may differ from the version of the ICD-10 approved by the Ministry of Health of Russia.

2. Translation into Russian of a series medical terms in this article may differ from the translation in the ICD-10 approved by the Ministry of Health of Russia. All comments and clarifications on translation, design, etc. are accepted with gratitude by e-mail.

3. NOS - without additional specifications.

4. NEC - not elsewhere classified.

5. A cross † marks the main codes of the underlying disease, which must be used without fail.

6. An asterisk marks optional additional codes related to the manifestation of the disease in a separate organ or area of the body, which is an independent clinical problem.

Source: http://www.gastroscan.ru/handbook/382/7735

What is fatty liver: ICD code 10

The development of fatty hepatosis is based on the violation of metabolic processes in the human body. As a result of this liver disease, healthy tissue of the organ is replaced by fatty tissue. At the initial stage of development, fat accumulates in hepatocytes, which over time simply leads to dystrophy of the liver cells.

Causes of fatty liver and its prevalence

The causes of the development of the disease have not yet been exactly proven, but factors are known that can surely provoke the onset of this disease. These include:

completeness;
diabetes;
violation of metabolic processes (lipid);
minimal physical activity with a nutritious daily diet high in fat.

Most cases of development of fatty hepatosis are recorded by physicians in developed countries with above-average living standards.

In medicine, it is very convenient to use the coding of diseases to systematize them. It is even easier to indicate a diagnosis on a sick leave using a code. Codes for all diseases are presented in the International Classification of Diseases, Injuries and Various Health Problems. The tenth revision is currently in effect.

You can learn more about the symptoms, diagnosis and treatment of hepatosis from separate materials:

Treatment of fatty liver

Source: http://zapechen.ru/bolezni-pecheni/gepatoz/mkb-10.html

Steatosis of the liver

ICD-10 code

Related diseases

Titles

Description

Symptoms

The reasons

Metabolic disorders - type 2 diabetes mellitus, obesity, hypertriglyceridemia;

The action of toxic factors - alcohol, certain toxic substances, drugs;

Unbalanced diet (overeating, starvation, lack of protein in food);

Chronic diseases of the digestive system with malabsorption syndrome and;

Fatty infiltration of the liver that is not associated with the effects of alcohol or other toxic substances is called primary or non-alcoholic steatosis (non-alcoholic fatty liver disease). Thus, liver damage is not always associated with the action of toxic factors (alcohol, drugs).

Today, the prevalence of non-alcoholic fatty liver disease is very significant. Approximately a quarter of the population in developed countries has steatosis of the liver, and 3.5-11% have non-alcoholic steatohepatitis, including cirrhosis of the liver. Obese people are diagnosed with non-alcoholic fatty liver disease much more often than people with normal weight.

Risk factors for severe disease:

Source: http://kiberis.ru/?p=30417