Clinical studies of alcoholic hepatic diseases.

Clinical features of 52 patients with alcoholic hepatic diseases were described. Of these patients 27 had alcoholic hepatic cirrhosis. As compared with hepatic cirrhosis due to icteric viral hepatitis, vascular spider, ascites and edema were found more frequently in alcoholic cirrhosis. Hepatic biopsy showed preponderance of cirrhotic changes of postnecrotic type. Twenty-five patients had alcoholic fatty liver with or without fibrosis. Hepatic enlargement was observed in 64% of the total patients, and abnormalities of the bromsulphalein test in 86%. Decreased hepatic blood flow, elevated hepatic venous pressure and increased per cent intrahepatic shunt were demonstrated in some patients. Seven patients with hepatic cirrhosis and 5 with fatty liver and fibrosis were found to have acute alcoholic hepatitis. Hepatic enlargement was observed in all such cases, and jaundice in 92%. The bromsulphalein test and serum glutamic oxalacetic transaminase were abnormal in all the cases. Serum glutamic oxalacetic transaminase levels were higher than serum glutamic pyruvic trans aminase levels in 71% of the patients. Zieve's syndrome was found in one of the patients with acute alcoholic hepatitis.