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General Medicine

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
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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Related Images
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Chronic hepatitis with cirrhosis. A photomicrograph of the liver from a patient with long-standing chronic active hepatitis B shows hepatocellular nodules and chronically inflamed fibrous septa.
Chronic hepatitis with cirrhosis. A photomicrograph of the liver from a patient with long-standing chronic active hepatitis B shows hepatoc...
Alcoholic cirrhosis. The surface of the liver displays innumerable small, regular nodules.
Alcoholic cirrhosis. The surface of the liver displays innumerable small, regular nodules.
Alcoholic cirrhosis. A photomicrograph shows small regular nodules surrounded by uniform fibrous septa.
Alcoholic cirrhosis. A photomicrograph shows small regular nodules surrounded by uniform fibrous septa.
Cirrhosis of the liver. The consequence of chronic hepatic injury is the formation of regenerating nodules separated by bands of fibrous connective tissue (blue).
Cirrhosis of the liver. The consequence of chronic hepatic injury is the formation of regenerating nodules separated by bands of fibrous co...
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