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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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