Cirrhosis

From Citizendium, the Citizens' Compendium

Cirrhosis is a "liver disease in which the normal microcirculation, the gross vascular anatomy, and the hepatic architecture have been variably destroyed and altered with fibrous septa surrounding regenerated or regenerating parenchymal nodules."^[1]

Contents 1 Complications 1.1 Ascites 1.2 Esophageal varices 1.3 Hepatic encephalopathy 1.4 Hepatorenal syndrome 1.5 Spontaneous bacterial peritonitis 1.6 Spontaneous bacteremia 2 Prognosis 2.1 MELD Score 2.2 Child-Pugh score 3 References

Complications

Ascites

For more information, see: Ascites.

Esophageal varices

Patients with a platelet count of less than 40 and a palpable spleen are more likely to have esophageal varices.^[2] Varices are also more likely according to a clinical prediction rule if a patient has an increased alanine transaminase (ALT) level, reduced albumin level, and presence of spider angiomas.^[3]

Hepatic encephalopathy

For more information, see: Hepatic encephalopathy.

Hepatorenal syndrome

For more information, see: Hepatorenal syndrome.

Spontaneous bacterial peritonitis

For more information, see: Spontaneous bacterial peritonitis.

Spontaneous bacteremia

Spontaneous bacteremia may occur.^[4][5] Mong patients with Child-Pugh Score indicating class C, half of bacteremias may not have a definite focus.^[5]

Prognosis

MELD Score

For more information, see: MELD Score.

The MELD Score can help predict mortality. An online calculator is available.

Child-Pugh score

For more information, see: Child-Pugh Score.

The Child-Pugh Score can help predict mortality. An online calculator is available.

References

1. ↑ Anonymous. Liver cirrhosis. National Library of Medicine. Retrieved on 2008-01-07.
2. ↑ Sharma SK, Aggarwal R (2007). "Prediction of large esophageal varices in patients with cirrhosis of the liver using clinical, laboratory and imaging parameters". J. Gastroenterol. Hepatol. 22 (11): 1909–15. DOI:10.1111/j.1440-1746.2006.04501.x. PMID 17914969.
3. ↑ Berzigotti A, Gilabert R, Abraldes JG, et al (May 2008). "Noninvasive prediction of clinically significant portal hypertension and esophageal varices in patients with compensated liver cirrhosis". Am. J. Gastroenterol. 103 (5): 1159–67. DOI:10.1111/j.1572-0241.2008.01826.x. PMID 18477345.
4. ↑ Ortiz J, Vila MC, Soriano G, et al (April 1999). Infections caused by Escherichia coli resistant to norfloxacin in hospitalized cirrhotic patients. Hepatology 29 (4): 1064–9. DOI:10.1002/hep.510290406. PMID 10094947.
5. ↑ ^5.0 5.1 Monte Secades R, Casariego Vales E, Mateos Colino A, et al (November 1999). "[Clinical profile and prognosis of bacteremia in patients with cirrhosis based on the Child-Pugh classification]" (in Spanish; Castilian). Rev Clin Esp 199 (11): 716–21. PMID 10638235.