Stroke and meningitis on the basis of cirrhosis
The patient is Ms. L.T.T, 74 years old, residing in Tuyen Quang, who has a history of drinking alcohol for more than 10 years with a consumption of about 500700ml/day. Despite being diagnosed with cirrhosis 10 years ago, the patient still maintains the habit of drinking alcohol every day.
About 10 days before being admitted to the hospital, the patient began to feel tired, painful, weak in the body, and have a crooked mouth - a suspected sign of a stroke. At the local medical facility, the patient was diagnosed with meningitis and cerebral infarction on the basis of severe cirrhosis. After 3 days of unimproved treatment, the patient was transferred to the Central Hospital for Tropical Diseases in a state of drowsiness and had to be placed in the trachea and on a ventilator.
MSc. Dr. Ha Viet Huy - Intensive Care Center - said: "The patient was admitted to the hospital with obvious multiple organ failure. The brain scan showed a large area of cerebral infarction with advanced cerebral edema. CerebralPHPHY has many abnormalities, the inflammation index is very high. The patient also suffered from severe jaundice, thrombocytopenia, and serious blood clotting disorder. This is a case of Bacterial meningitis that combines a stroke, which is extremely complicated due to decompensive cirrhosis and a damaged immune system after many years of alcoholism".
Infection shock, massive gastrointestinal bleeding
Another case is Mr. N.V.C, 53 years old, residing in Bac Ninh, with a history of drinking alcohol for 1015 years, an average of 300500ml/day. The patient was admitted to the lower hospital due to umbilical hernia and was indicated for surgery. However, after surgery, the patient quickly fell into a state of post-operative infection and septic shock due to severe cirrhosis, forcing him to be transferred to the Intensive Care Unit.
"After surgery, there was severe cirrhosis and he was transferred to the Central Hospital for Tropical Diseases. In the first days, the patient had an infectious shock condition, the condition is improving. But on the third day, he suddenly vomited heavily, his blood pressure dropped rapidly - a typical manifestation of expanded Esophageal Venous system, a complication commonly seen in people with cirrhosis, said Dr. Ha Viet Huy.
In a short time, the patient was both shocked by infection and shocked by volume reduction due to gastrointestinal bleeding. Although he was resuscitated positively, his prognosis was very unfortunate, so his family asked to let him go home.
Drinking nearly 1 liter of alcohol/day for 20 years
The third case was Mr. T.V.G, 56 years old, residing in Hung Yen, who has been drinking alcohol for more than 20 years with an amount of nearly 1 liter per day. The patient was diagnosed with cirrhosis 7 years ago but did not receive treatment. 2 days before being admitted to the hospital, the patient had difficulty breathing, low blood pressure, drowsiness, had to be placed in the endotracheal tube at a local hospital and transferred to a higher level in a state of severe septic shock, requiring high doses of vasopressors.
Test results showed severe blood clotting disorder, very low platelets, bilan infection reached the maximum level according to the machine threshold, accompanied by gastrointestinal bleeding - a typical sign of irreversible liver failure and damage to multiple organ failure throughout the body, the risk of death is very high.
According to Dr. Huy: In people with severe liver fibrosis due to alcohol, the immune system and organ protection mechanisms are almost wiped out. When there is an infection or digestive complication, the body is not able to fight it. The state of "shock overlapping" - both infectional, acute liver failure, and blood loss - makes recovery extremely difficult.
MSc. Dr. Ha Viet Huy warned: People who have been diagnosed with cirrhosis should absolutely not drink alcohol - even in small doses. Signs such as prolonged fatigue, leg swelling, jaundice, subcutaneous hemorrhage, changes in consciousness... are red alert signals that need to be hospitalized immediately. cirrhosis is not treated as an pre-existing triggers, as long as a triggering factor such as infection or bleeding can lead to critical complications or death.
