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Hepatic coma:Treatment emphasizing merit of peritoneal dialysis

Authors
Journal
The American Journal of Surgery
0002-9610
Publisher
Elsevier
Publication Date
Volume
106
Issue
6
Identifiers
DOI: 10.1016/0002-9610(63)90167-3
Disciplines
  • Biology
  • Medicine

Abstract

Abstract 1. 1. The liver diseases most often associated with hepatic coma are Laennec's cirrhosis and acute viral hepatitis. 2. 2. Coma may be precipitated in these patients by blood in the intestine, high protein diet, paracentesis, ammonium chloride, chlorothiazide, transfusion reaction, urea and hypokalemia. 3. 3. Ammonia is probably the principal toxic substance responsible for hepatic coma. 4. 4. Treatment of the syndrome includes marked restriction of protein intake, elimination of blood and protein from the gastrointestinal tract, intestinal antibiotics, arginine, sodium glutamate, correction of fluid and electrolyte imbalances particularly hypokalemia, corticosteroids, oral exchange resins, perfusion through exchange resins and dialysis using the peritoneum or artificial kidney. 5. 5. The merit of peritoneal dialysis in the treatment of hepatic coma is emphasized. A deeply comatose, moribund patient with homologous serum hepatitis was treated with this method. Rapid clinical improvement heralded complete recovery.

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