Does fatty liver hurt? These symptoms are the most common

Nowadays, people are very likely to get fatty liver, which has a lot to do with daily diet and lifestyle. Patients with fatty liver will also have symptoms of abdominal pain, which is most obvious in the upper right abdomen. They are also prone to fatigue, nausea, loss of appetite, abdominal distension and other symptoms.

1. Acute microvesicular fatty liver The clinical manifestations of acute microvesicular fatty liver are similar to those of acute or subacute severe viral hepatitis, often with fatigue, nausea, vomiting, and varying degrees of jaundice, and even impaired consciousness and epileptic seizures. In severe cases, hepatic encephalopathy, ascites, renal failure, and disseminated intravascular coagulation (DIC) develop rapidly in a short period of time, and may eventually lead to death from cerebral edema and brain herniation. Of course, some cases of acute microvesicular fatty liver have mild clinical manifestations, with only transient vomiting and liver function damage. Liver biopsy showed microvesicular fatty degeneration, but inflammatory cell infiltration and necrosis were not obvious, and electron microscopy showed mitochondrial abnormalities.

2. Chronic bullous fatty liver Chronic bullous fatty liver is commonly known as fatty liver, which is more common in middle-aged and elderly people, and may be more common in men than in women. The onset is insidious, the course is generally benign, and the symptoms are mild and nonspecific. Even if fatty liver hepatitis and cirrhosis have occurred, liver disease-related symptoms may sometimes be absent, so it is often discovered accidentally during the evaluation of other diseases or health examinations such as liver function and imaging tests.

Liver enlargement is a common sign of fatty liver, with an incidence rate of over 75%. Most cases are mild to moderate liver enlargement, with a smooth surface, rounded edges, normal or slightly hard texture, and no obvious tenderness. Signs of chronic liver disease, such as portal hypertension, are relatively uncommon, and the detection rate of splenomegaly in cases of steatohepatitis generally does not exceed 25%. The clinical manifestations of focal fatty liver are not obvious due to the small range of lesions, but this is an exception when other liver diseases coexist.

(1) Symptoms: Mild fatty liver may not have any clinical symptoms, especially in the elderly due to overeating or high-fat diet, which is clinically called "hidden fatty liver". Moderate or severe patients, especially those with a long course of illness, have more obvious symptoms. Common symptoms include fatigue, loss of appetite, right hypochondrium pain, nausea, abdominal distension and other symptoms of liver dysfunction. It may be accompanied by abdominal pain, mainly in the right upper abdomen, occasionally in the middle and upper abdomen, accompanied by tenderness. In severe cases, there is rebound pain, fever, and increased white blood cell count, which are similar to the manifestations of acute abdomen and need to be treated promptly. This manifestation is rare. During the operation, it was found that the liver capsule was stretched and the liver ligaments were involved. The patient's pain was caused by the stretching of the liver capsule, the pulling of the liver ligaments, the rupture and inflammation of the fat cyst, etc. Severe fatty liver may be complicated by portal hypertension and gastrointestinal bleeding. At the same time, vitamin deficiency may be accompanied by anemia, glossitis, peripheral neuritis and neurological symptoms, ascites and lower limb edema, and other symptoms may include spider nevi, male breast development, testicular atrophy, impotence, amenorrhea and infertility in women.

(2) Physical signs: 64% of the subjects were overweight or obese. Liver enlargement accounts for 15%, and there may be percussion tenderness in the liver area, splenomegaly, and spider nevi and liver palms on the skin.