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Cirrhosis of the Liver

Liam P. Burke, MD Reviewed 04/2024
 


BASICS

DESCRIPTION

A chronic inflammatory disease with hepatocellular dysfunction, fibrosis, necrosis, and vascular remodeling possibly leading to liver failure and/or cancer 

EPIDEMIOLOGY

  • Diagnosis: ty...

DIAGNOSIS

HISTORY

  • Review risk factors (alcohol use, viral hepatitis, and family history of primary liver cancer, liver disease, or autoimmune disease).

  • Symptoms

    • Fatigue, malaise, weakness, anorexia, weig...

TREATMENT

Outpatient care for all acute and chronic HCV patients, except during major GI bleeding, AMS, sepsis/infection, rapid hepatic decompensation, or renal failure 

GENERAL MEASURES

  • Abstain from al...

ONGOING CARE

  • Monitor liver enzymes, sodium, creatinine, platelets, and PT q6–12mo; calculate MELD score

  • Serial α-fetoprotein and liver ultrasound screening q6–12mo in patients with cirrhosis. Patients ...

REFERENCES

1
Ginès P, Krag A, Abraldes JG, et al. Liver cirrhosis. Lancet. 2021;398(10308):1359-1376. doi: 10.1016/S0140-6736(21)01374-X. PMID: 34543610

ADDITIONAL READING

  • Sharma R, Zhao W, Zafar Y, et al. Serum hepcidin levels in chronic liver disease: a systematic review and meta-analysis. Clin Chem Lab Med. 2023. doi: 10.1515/c...

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

SNOMED

  • 19943007 Cirrhosis of l...

CLINICAL PEARLS

  • 80% of CLD is preventable (primarily alcohol abuse, hepatitides).

  • After diagnosis of cirrhosis, abdominal ultrasound every 6-12 months for early detection of HCC.

  • Update necessary immuni...

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