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Cirrhosis of the Liver

Kathleen M. Donahue, DO and Daniel B. Machue, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

A chronic hepatocellular disease with inflammation, necrosis, and fibrosis potentially leading to liver failure and/or cancer 

EPIDEMIOLOGY

  • Predominant age: 40 to 50 years old

  • Predomina...

DIAGNOSIS

HISTORY

  • Review risk factors (alcohol abuse, viral hepatitis, family history of primary liver cancer, other liver disease, or autoimmune disease)

  • Symptoms

    • Fatigue, malaise, weakness

    • Anorexia, w...

TREATMENT

Outpatient care except for major GI bleeding, altered mental status, sepsis/infection, rapid hepatic decompensation, and renal failure 

GENERAL MEASURES

  • Abstain from alcohol, drugs, hepatotoxi...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Regular physical conditioning may help with fatigue. 

Patient Monitoring

  • Once stable, monitor liver enzymes, platelets, and PT q6–12mo.

  • Patients >55 years with ch...

REFERENCES

1
1 Hart CL, Morrison DS, Batty GD, et al. Effect of body mass index and alcohol consumption on liver disease: analysis of data from two prospective cohort studies. BMJ.  2010;340:c1240...

ADDITIONAL READING

  • Chou R, Wasson N. Blood tests to diagnose fibrosis or cirrhosis in patients with chronic hepatitis C virus infection: a systematic review. Ann Intern Med.  2013;158(11):807–820...

SEE ALSO

Algorithm: Cirrhosis 

CODES

ICD10

  • K74.60 Unspecified cirrhosis of liver

  • K70.30 Alcoholic cirrhosis of liver without ascites

  • K74.69 Other cirrhosis of liver

  • K76.1 Chronic passive congestion of liver

ICD9

  • 571.5 Cirrhosis of liver ...

CLINICAL PEARLS

  • 80% of chronic liver disease that leads to cirrhosis is preventable (primarily alcohol abuse).

  • After diagnosis of cirrhosis, abdominal ultrasound every 6 months for early detection of h...

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