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General Medicine

Cirrhosis of the Liver

Liam P. Burke, MD and Anna K. Zheng, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

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

EPIDEMIOLOGY

  • Predominant age at diagnosis: 40 to 60 years...

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, we...

TREATMENT

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

GENERAL MEASURES

  • Abstain from alcohol, drugs, hepatotoxic...

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
Singh S, Venkatesh SK, Wang Z, et al. Diagnostic performance of magnetic resonance elastography in staging liver fibrosis: a systematic review and meta-analysis of individual participant d...

ADDITIONAL READING

  • Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver D...

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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