Cirrhosis of the liver

Posted by e-Medical PPT
Cirrhosis is a common chronic, progressive and diffusive liver disease, caused by one or several agents act repeatedly and persistently.
Histologically, cirrhosis is an irreversible alteration of the liver architecture, consisting of hepatic fibrosis and areas of nodular regeneration

Etiology and pathogenesis
Viral hepatitis
Parasites (schistosomiasis)
Alcoholic liver disease
Cholestasis
Hepatic-Venous outflow obstruction
    Veno-occlusive disease
     Budd-chiari syndrome
     Constrictive pericarditis
     Chronic congestive heart failure
Toxicant and drugs
Metabolic abnormality
Malnutrition
Cryptogenic cirrhosis

Clinical manifestation
Compensated stage                                              Decompensated stage
Fatigue                                                                 Deterioration of liver function
Loss of appetite                                                   Feature of portal hypertention
Anorexia                                                                   Portal-systemic collaterals
Abdominal discomfort                                              Ascites
Abdominal pain                                                        Splenomegaly
Hepatomegaly (slightly or moderately)
Splenomegaly

Ascites
Prominent feature of portal-hypertension
70% of patients are positive
An early sign in presinusoidal portal hypertension
Relative late in intrahepatic portal hypertension
Massive ascites:  abdominal herniae

Complications
 Upper gastrointestinal bleeding
 Hepatic encephalopathy
 Infection
 Hepatorenal syndrome
 Primary liver cancer
 Imbalance of electrolytes and acid-alkaline

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