LIVER

CIRRHOSIS

By Francis Adrian Palalon

OVERVIEW
Cirrhosis is a late stage of scarring (fibrosis) of the

liver. The liver carries out several necessary

functions, including detoxifying harmful substances
in your body, cleaning your blood and making vital
nutrients.
Cirrhosis occurs in response to damage to your liver.
Each time your liver is injured, it tries to repair itself.
As cirrhosis progresses, more and more scar tissue
forms, making it difficult for the liver to function.

DEFINITION OF TERMS
a)

ascites - the accumulation of fluid in the peritoneal cavity,

causing abdominal swelling

b) decompensated - is the functional deterioration of a

previously working structure or system

c) detoxify - removal of toxic substances from a living organism,

including the human body

d) elastography - a medical imaging modality that maps the

elastic properties of soft tissue

e) varices - are dilated veins in the distal esophagus or proximal

stomach caused by elevated pressure in the portal venous

system, typically from cirrhosis

f) bout - a short period of intense activity of a specified kind

g) biliary - of or relating to bile or the bile duct

ETIOLOGY
Hepatitis C, fatty liver, and alcohol abuse are the most

common causes of cirrhosis of the liver

Others include:
Fatty liver
Chronic viral infections of the liver
Blockage of the bile duct
Glycogen storage diseases
Diseases caused by abnormal liver function;
hemochromatosis & Wilson's disease

SIGNS/SYMPTOMS
Loss of appetite
Lack of energy (fatigue)
Weight loss or sudden weight gain
Bruises
Yellowing of skin or the whites of eyes (jaundice)
Itchy skin
Fluid retention (edema) and swelling in the ankles, legs, and abdomen

(often an early sign)

Confusion, disorientation, personality changes
Blood in the stool
Fever

a) Alcoholic cirrhosis

TYPES OF CIRRHOSIS

- in which the scar tissue characteristically surrounds the portal areas.

This is most frequently caused by chronic alcoholism and is the most
common type of cirrhosis.
b) Postnecrotic cirrhosis
- in which there are broad bands of scar tissue. This is a late result of a
previous bout of acute viral hepatitis.
c) Biliary cirrhosis
- in which scarring occurs in the liver around the bile ducts. This type of
cirrhosis usually results from chronic biliary obstruction and infection
(cholangitis); it is much less common.
d) Cardiac cirrhosis
- includes a spectrum of hepatic derangements that occur in the setting of
right-sided heart failure

LAB & DIAGNOSTICS TEST

Liver biopsy. A procedure in which a small needle is

inserted into the liver to collect a tissue sample.

Liver function. Your blood is checked for excess
bilirubin, which is a product of red blood cells breaking
down, as well as for certain enzymes that may
indicate liver damage.
Kidney function. Your blood is checked for creatinine
as kidney function may decline in later stages of
cirrhosis (decompensated cirrhosis).
Tests for hepatitis B and C. Your blood is checked for
the hepatitis viruses.

Clotting. Your international normalized

ratio (INR) is checked for your blood's

ability to clot.
Magnetic resonance elastography or
transient elastography. These
noninvasive imaging tests detect
hardening or stiffening of the liver and
may eliminate the need for a liver
biopsy.
Other imaging tests. MRI, CT and
ultrasound create images of the liver.
Biopsy. A tissue sample (biopsy) is not

MANAGEMENT

Treatment for alcohol dependency.

- People with cirrhosis caused by alcohol abuse

should stop drinking.

Weight loss.

- People with cirrhosis caused by nonalcoholic fatty

liver disease may become healthier if they lose
weight and control their blood sugar levels.

 Medications to control hepatitis.

- Antiviral medications. Several antiviral medications

including lamivudine (Epivir), adefovir (Hepsera),
telbivudine (Tyzeka) and entecavir (Baraclude).
Medications to control other causes and

symptoms of cirrhosis.

- Talk to your doctor about all of the medicines you

take, including nonprescription drugs such as
acetaminophen (for example, Tylenol), aspirin,
ibuprofen (for example, Advil or Motrin), and
naproxen (Aleve).

THANK YOU.
The secret to success is knowing who
to blame your failures.