LIVER

CIRRHOSIS
Fardah Akil

INTRODUCTION
Definition :
Fibrosis & nodular regeneration
resulting from hepatocellular
injury
Epidemiology :
Cirrhosis & CLD accounted for >
25.000 death & 375.000
hospitalization

ETIOLOGY
Alcohol
Virus

Hepatitis : chronic HBV,HCV, HDV infection

Autoimmune hepatitis (female, IgG, +ANA, +ASMA)
Cogenital : hemocromatosis, wilsons disease, -1antitrypsin deficiency,
cogenital hepatic fibrosis
Metabolic disease : NASH/NAFLD
Biliary tract disease : PBC/PSC, secondary biliary cirrhosis (calculus,
neoplasm,post-op stricture, biliary atresia)
Vascular disease : Budd-Chiari syndrome, R-side heart failure, constrictive
pericarditis
Cryptogenic : may reflect terminal progression of NAFLD or some may be
non/missed diagnosed AIH

PATHOPHYSIOLOGY
A late stage of progressive
hepatic fibrosis
characterized by
distortion of hepatic
architecture & formation
of regenerative nodules

CLINICAL MANIFESTATION

Subclinical or present at
progressive liver dysfunction
(jaundice, coagulopathy,
encephalopathy) and/or
portal hypertension (ascites,
varices)

Liver : enlarged, palpable,

firm, nodular >> shrunken &
nodular

Sign of liver failure :

Jaundice, spider
angiomata (marker of
chronicity), palmar
erytema, duputyrens
contracture, white nail
lines (muehrckes line) &
proximal nail beds (terrys
nail), parotid & lacrimal
glands, gynecomasti