Definition Cirrhosis is a chronic condition involving the whole - - PDF document

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Cirrhosis Definition

• Cirrhosis is a chronic condition involving

the whole liver which results from long, continued loss of liver cells, with a persistent inflammatory reaction accompanied by fibrosis and hyperplasia.

• The condition is irreversible.

Causes

• Toxins - Alcohol, drugs
• Infective - Hep B, C,
• Metabolic - Haemochromatosis, Wilsons,

NASH

• Autoimmune - CAH, PBC, PSC
• Mechanical - CCF
• Cryptogenic

Clinical features

• 1. Asymptomatic - compensated
• 2. Symptomatic - decompensated
• 2a. Liver failure
• 2b. Portal hypertension

Clinical features

• Hands - clubbing, leuconychia, palmar

erythema, dupuytrens

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Clinical features

• facial telangiectasia

Clinical features

• spider naevi, varices, gynaecomastia, hair

loss

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Clinical features

• hepatomegaly, splenomegaly
• jaundice, ascites, encephalopathy

Clinical features

• Hands - clubbing, leuconychia, palmar

erythema, dupuytrens

• facial telangiectasia
• spider naevi, varices, gynaecomastia, hair

loss

• hepatomegaly, splenomegaly
• jaundice, ascites, encephalopathy

Clinical / Lab features

• Anaemia
• hypoproteinaemia
• thrombocytopenia
• coagulopathy
• abnormal LFTs

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Complications

• Fatigue, confusion, sepsis,coma
• malnutrition
• GI bleeding - varices, ulceration
• Renal failure
• Hepatoma

Management - general

• Treat cause
• avoid dehydration
• avoid constipation
• treat sepsis
• ensure adequate nutrition
• avoid sedating drugs

Management - specific

• Ascites - diuretics, drainage

Management - specific

• Ascites - diuretics, drainage
• confusion - hydration, nutrition, treat sepsis

Management - specific

• Ascites - diuretics, drainage
• confusion - hydration, nutrition, treat sepsis
• bleeding - (b blockers), resuscitation,

endoscopic therapy, antibiotics

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Management - specific

• TIPSS

Management - specific

• Liver transplantation