title: Severe steatohepatitis with hepatic decompensation resulting from malnutrition after pancreaticoduodenectomy.
abstract: The most common finding related to nonalcoholic steatohepatitis is obesity, but a status of severe malnutrition can also induce the steatohepatitis. The authors report a rare case of steatohepatitis leading to hepatic decompensation caused by malnutrition after pancreaticoduodenectomy. A 68-year-old female patient who had been previously diagnosed with pancreatic cancer and had undergone pancreaticoduodenectomy 5 months previously presented with abdominal distension. Routine CT performed 3 months after the surgery revealed severe fatty liver without evidence of tumor recurrence. After undergoing pancreaticoduodenectomy her food intake had reduced, and as a result she had lost 7 kg of body weight over 2 months. At this admission, CT revealed moderate amounts of ascites without tumor recurrence. Furthermore, her albumin and lipid profile levels were markedly decreased, and she had a flapping tremor and slurred speech suggestive of hepatic encephalopathy. Her liver biopsy findings were consistent with steatohepatitis and disclosed macrovesicular steatosis without definite fibrosis. After careful nutritional control, her symptoms disappeared and her laboratory findings improved.
authors: Department of Internal Medicine, Incheon St. Mary's hospital, The Catholic University of Korea College of Medicine, Incheon, Korea.
authors: Eun Hui
authors: EH
authors: Sim
authors: Jung Hyun
authors: JH
authors: Kwon
authors: Se Young
authors: SY
authors: Kim
authors: Seung Min
authors: SM
authors: Jung
authors: Lee-So
authors: LS
authors: Maeng
authors: Jeong Won
authors: JW
authors: Jang
authors: Kyu Won
authors: KW
authors: Chung
mesh_terms: D000368:Aged; D001201:Ascites / Q000209:etiology; D005234:Fatty Liver / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D008111:Liver Function Tests; D044342:Malnutrition / Q000150:complications*; D010190:Pancreatic Neoplasms / Q000601:surgery; D016577:Pancreaticoduodenectomy; D014057:Tomography, X-Ray Computed
keywords: Hepatic decompensation; Malnutrition; Nonalcoholic steatohepatitis; Pancreatic cancer; Pancreaticoduodenectomy