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| CASE REPORTS |
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| Severe steatohepatitis with hepatic decompensation
resulting from malnutrition after pancreaticoduodenectomy |
| Eun Hui Sim1, Jung Hyun Kwon1, Se Young Kim1, Seung Min Jung1, Lee-So Maeng2, Jeong Won Jang1, and Kyu Won Chung1 |
| 1Department of Internal Medicine and 2Department of Hospital Pathology, Incheon St. Mary¡¯s hospital, The Catholic University of Korea College of Medicine, Incheon, Korea |
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Corresponding Author:
Jung Hyun Kwon ,Tel: +82-32-280-5020, Fax: +82-32-280-5987, Email: doctorkwon@catholic.ac.kr |
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| ABSTRACT |
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| 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. |
| Keywords: Nonalcoholic steatohepatitis; Malnutrition; Pancreaticoduodenectomy; Pancreatic cancer; Hepatic decompensation |
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