Answer to Question 1
A combination of increased influx of fatty acids from adipose stores, enhanced hepatic synthesis of triglycerides from fatty acids derived from the diet, decreased fatty acid oxidation, and impaired hepatic lipoprotein synthesis are all of apparent importance in pathogenesis.
Fat begins to be stored in the liver. Hepatomegaly occurs with abdominal tenderness. A postnecrotic pattern may begin to develop, leading to cirrhosis. However, since only 1 out of 12 alcoholics develop cirrhosis, it has been suggested that unknown constitutional or genetic factors also play an important role.1
Answer to Question 2
Pros: if patients do not feel like eating and are nutritionally compromised, or have been significantly compromised prior to surgery, the liberal approach will help them to recover quickly.
Cons: the patient may see the diet as not being as important as we would like them to believe. Also, the patient may become very concerned as Mr. F did. It would have been more appropriate for Mr. F to have been informed of the type of meals he was going to receive and why prior to receiving the meals.