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Causes: CITTTAN: Liver Cirrhosis

Liver cirrhosis is scarring of the liver caused by various factors that damage hepatocytes over time. These factors include biliary obstruction, cystic fibrosis, infections like hepatitis, toxins like alcohol, and autoimmune or metabolic diseases. The progression is from a normal liver to fatty liver to fibrosis to cirrhosis. Cirrhosis can be compensated or decompensated, with decompensated cirrhosis showing symptoms like jaundice, ascites, bleeding, and hepatic encephalopathy. Investigations include blood tests and imaging, while treatment focuses on supportive care, managing complications, and potentially liver transplantation in severe cases.

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Ahmed almahdi
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41 views

Causes: CITTTAN: Liver Cirrhosis

Liver cirrhosis is scarring of the liver caused by various factors that damage hepatocytes over time. These factors include biliary obstruction, cystic fibrosis, infections like hepatitis, toxins like alcohol, and autoimmune or metabolic diseases. The progression is from a normal liver to fatty liver to fibrosis to cirrhosis. Cirrhosis can be compensated or decompensated, with decompensated cirrhosis showing symptoms like jaundice, ascites, bleeding, and hepatic encephalopathy. Investigations include blood tests and imaging, while treatment focuses on supportive care, managing complications, and potentially liver transplantation in severe cases.

Uploaded by

Ahmed almahdi
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Liver cirrhosis

Definition
Hepatocytes necrosis
Increase echogenicity
Causes: CITTTAN
 Biliary obstruction
 Cystic fibrosis,&1-ATD,
 Infection: hepatitis&cholangitis
 Toxins: afla toxin, drugs & others
 Autoimmune chronic active hepatitis
 Metabolic: Wilson disease, hemochromatosis
 Chronic hepatic congestion e.g. cardiac cirrhosis

Normal liver  Fatty liver  Liver fibrosis  Liver cirrhosis

Clinical picture:
A- Compensated:
B- Decompensated:
 Jaundice
 Spider nevi
 Gynecomastia
 Finger clubbing
 Muscle wasting
 Palmar erythema
 Ascites& G.edema
 Bleeding tendency
 Portal hypertension
 Hepato-renal syndrome
 Hepatic encephalopathy
 Hepato-pulmonary syndrome
Investigations:
 CBC
 LFT
  PT
 Albumin
 Gamma globulin
 Search for the cause
 Abd. U/S
 Liver biopsy

Head of P.W. Dr. Noura Noreddeen


Complications:
 Weight loss
 Nutrient loss
 Hormonal disturbances
 Hepatocellular carcinoma
 Portal HTN& its complications
Treatment:
Supportive& specific
A-compensated:
 Low fat diet
 Low salt diet
 Low protein diet
 CHO& vitamin support
 Treat the cause as Wilson
 Eliminate toxins e.g. Quat
B- Decompensated:
 Treatment of complications
 Supportive liver transplantation
 Surgical correction for biliary anomalies
 Immuno-suppresant for autoimmune hepatitis
 Jaundice:
 Ursodeoxycholic acid
 Muscle wasting:
 Nutritional support
 Ascites& G.edema
 Albumin infusion& spironolactone
 Bleeding tendency:
 Vitamin K IV& FFP
 Hepatic encephalopathy:
 Lactulose, neomycin, Mannitol& KCl in IVF
 Hepato-renal syndrome:
 Spironolactone
 Treatment of complications:
Hematemesis from esophageal varices:
 Ligation or sclerotherapy
Prognosis:
 Usually poor
 Death in 1 year in:
 Rising bilirubin
 Refractory ascites
 Refractory bleeding

Head of P.W. Dr. Noura Noreddeen

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