Cirrhosis is a late stage of hepatic fibrosis that has resulted in widespread distortion of normal hepatic architecture. Cirrhosis is characterized by regenerative nodules surrounded by dense fibrotic tissue. Various types of chronic liver injury can cause cirrhosis, like hepatitis B or C, alcoholic or non alcoholic liver disease.
Portal hypertension is the most common serious complication of cirrhosis, and it, in turn, causes complications, including:
- Gastrointestinal (GI) bleeding from esophageal, gastric, or rectal varices and portal hypertensive gastropathy
- Acute kidney injury (hepatorenal syndrome)
- Pulmonary hypertension (portopulmonary hypertension)
- Hepatopulmonary syndrome (intrapulmonary shunt)
Symptoms and Signs
Cirrhosis often has no signs or symptoms until liver damage is extensive.
Often, the first symptoms are nonspecific, they include generalized fatigue, anorexia, malaise, and weight loss.
The liver is typically palpable and firm, with a blunt edge and sometimes small and difficult to palpate.
- Liver tests, coagulation tests, complete blood count (CBC), and serologic tests for viral causes
- Liver biopsy (when clinical and noninvasive tests are inconclusive)
- Ultrasound elastography or magnetic resonance elastography
- Treatment is supportive and includes stopping or adjusting doses of drugs metabolized in the liver drugs, nutrition, and treating the underlying disorders and complications.
- All alcohol and hepatotoxic substances must be avoided.