TERAPIA DELLA CIRROSI EPATICA SCOMPENSATA

After a brief introduction to the physiopathology of the liver, the therapeutic approaches to the water retention syndrome and portasystemic encephalopathy in liver cirrhosis with functional failure are enumerated. Personal experience with 120 cases of liver cirrhosis, indicates that correction of water retention may be achieved by dietary sodium restriction, the use of diuretics, paracentesis, infusion of plasmatic proteins and, in the case of patients who are resistant, reinfusion of autogenous ascites. The importance of avoiding hypokalemia is stressed because of the known effect of this condition on renal ammoniogenesis. The therapy indicated for acute and chronic encephalopathy is described. This is based on recently acquired physiopathological data. The results obtained in the treatment of these patients with the drugs now available is assessed.