Acute Pseudohepatitis in a Chronic Substance Abuser Secondary to Occult Seat Belt Injury

Causes of a massive elevation in serum aminotransferases (aspartate aminotransferase [AST] and alanine aminotransferase [ALT]) in the substance-abusing patient include viral hepatitis and drug hepatotoxicity. A patient chronically addicted to injection heroin and cocaine presented to the emergency r...

Full description

Saved in:
Bibliographic Details
Main Authors: Eric CS Lam, Rhonda M Janzen, R Mark Meloche, Paul J Trepanier, Eric M Yoshida
Format: Article
Language:English
Published: Wiley 1999-01-01
Series:Canadian Journal of Gastroenterology
Online Access:http://dx.doi.org/10.1155/1999/864912
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850208222096392192
author Eric CS Lam
Rhonda M Janzen
R Mark Meloche
Paul J Trepanier
Eric M Yoshida
author_facet Eric CS Lam
Rhonda M Janzen
R Mark Meloche
Paul J Trepanier
Eric M Yoshida
author_sort Eric CS Lam
collection DOAJ
description Causes of a massive elevation in serum aminotransferases (aspartate aminotransferase [AST] and alanine aminotransferase [ALT]) in the substance-abusing patient include viral hepatitis and drug hepatotoxicity. A patient chronically addicted to injection heroin and cocaine presented to the emergency room in a confused state and was admitted to a medical ward with an AST of 4120 U/L, ALT 3820 U/L and right upper quadrant discomfort. Investigations for viral and hepatotoxic causes for the liver dysfunction revealed only hepatitis C seropositivity. A computed tomogram of the abdomen, however, revealed a significant contusion to the right lobe of the liver consistent with traumatic injury. A motor vehicle accident, in which the patient was wearing a seat belt, and which had occurred a few days before admission and had been thought to be minor, was the cause of the liver dysfunction. Significant blunt abdominal traumatic injuries are usually managed exclusively by surgical trauma units. This case underlines the need for medical specialists to be aware of hepatic contusion injuries and to have a high index of suspicion when investigating unexplained hepatocellular dysfunction in chronic substance abusers who have been in motor vehicle accidents.
format Article
id doaj-art-9931aa10570a4907840b64dc07071cd9
institution OA Journals
issn 0835-7900
language English
publishDate 1999-01-01
publisher Wiley
record_format Article
series Canadian Journal of Gastroenterology
spelling doaj-art-9931aa10570a4907840b64dc07071cd92025-08-20T02:10:17ZengWileyCanadian Journal of Gastroenterology0835-79001999-01-0113215515810.1155/1999/864912Acute Pseudohepatitis in a Chronic Substance Abuser Secondary to Occult Seat Belt InjuryEric CS Lam0Rhonda M Janzen1R Mark Meloche2Paul J Trepanier3Eric M Yoshida4Department of Medicine, University of British Columbia, Vancouver, British Columbia, CanadaDepartment of Surgery, University of British Columbia, Vancouver, British Columbia, CanadaDepartment of Surgery, University of British Columbia, Vancouver, British Columbia, CanadaDepartment of Radiology, University of British Columbia, Vancouver, British Columbia, CanadaDepartment of Medicine, University of British Columbia, Vancouver, British Columbia, CanadaCauses of a massive elevation in serum aminotransferases (aspartate aminotransferase [AST] and alanine aminotransferase [ALT]) in the substance-abusing patient include viral hepatitis and drug hepatotoxicity. A patient chronically addicted to injection heroin and cocaine presented to the emergency room in a confused state and was admitted to a medical ward with an AST of 4120 U/L, ALT 3820 U/L and right upper quadrant discomfort. Investigations for viral and hepatotoxic causes for the liver dysfunction revealed only hepatitis C seropositivity. A computed tomogram of the abdomen, however, revealed a significant contusion to the right lobe of the liver consistent with traumatic injury. A motor vehicle accident, in which the patient was wearing a seat belt, and which had occurred a few days before admission and had been thought to be minor, was the cause of the liver dysfunction. Significant blunt abdominal traumatic injuries are usually managed exclusively by surgical trauma units. This case underlines the need for medical specialists to be aware of hepatic contusion injuries and to have a high index of suspicion when investigating unexplained hepatocellular dysfunction in chronic substance abusers who have been in motor vehicle accidents.http://dx.doi.org/10.1155/1999/864912
spellingShingle Eric CS Lam
Rhonda M Janzen
R Mark Meloche
Paul J Trepanier
Eric M Yoshida
Acute Pseudohepatitis in a Chronic Substance Abuser Secondary to Occult Seat Belt Injury
Canadian Journal of Gastroenterology
title Acute Pseudohepatitis in a Chronic Substance Abuser Secondary to Occult Seat Belt Injury
title_full Acute Pseudohepatitis in a Chronic Substance Abuser Secondary to Occult Seat Belt Injury
title_fullStr Acute Pseudohepatitis in a Chronic Substance Abuser Secondary to Occult Seat Belt Injury
title_full_unstemmed Acute Pseudohepatitis in a Chronic Substance Abuser Secondary to Occult Seat Belt Injury
title_short Acute Pseudohepatitis in a Chronic Substance Abuser Secondary to Occult Seat Belt Injury
title_sort acute pseudohepatitis in a chronic substance abuser secondary to occult seat belt injury
url http://dx.doi.org/10.1155/1999/864912
work_keys_str_mv AT ericcslam acutepseudohepatitisinachronicsubstanceabusersecondarytooccultseatbeltinjury
AT rhondamjanzen acutepseudohepatitisinachronicsubstanceabusersecondarytooccultseatbeltinjury
AT rmarkmeloche acutepseudohepatitisinachronicsubstanceabusersecondarytooccultseatbeltinjury
AT pauljtrepanier acutepseudohepatitisinachronicsubstanceabusersecondarytooccultseatbeltinjury
AT ericmyoshida acutepseudohepatitisinachronicsubstanceabusersecondarytooccultseatbeltinjury