T. Ichikawa

Relation to subacute hepatitis and liver cirrhosis

A man of fifty-four years old had fallen ill with unconsciousness and muscle convulsion four years ago and then we est imated high levels of 7-globulin and t r ansaminase in se rum and of blood-ammonia. He continued drinking until he had again abdominal swelling, general edema and hemorrhagic signs and was soon admit ted to our clinic. According to the needle biopsy his liver was rebuilt with pseudoacinus, relative narrow and poor cellinfiltrating in ters t i tums. Six mon ths after his admission suddenly hematoemes is f rom esophageal varix appeared and two weeks later esophageal t ransect ion was performed with blood t ransfus ion (total 3200 ml). In two and half month af ter the operation he was at tacked by fever-remission, yellow dyeing of the skin and ascites with psychic agitation. Icterus index showed from 42 to 180, GOT 1020 and GPT 600 in se rum and leucocytes increased from 2000 to 16200 and we caught a reduction of the liver. In three-weeks-course he died. Autopsy findings demons t ra ted small liver (800 gr) and melted liver cell with massive necrosis and s t rong infiltrating leucocytes especially in inters t i tums and splenitis was found. We diagnosed him as a serumhepat i t i s with a subacute type on the basis of the livercirrhosis.