Cirrhosis
Chronic liver/hepatic disease loss of normal structure and function of liver from a diffuse disorganisation and destruction of the normal liver structure by regenerative nodules surrounded by fibrotic tissue alters structure and impairs blood and lymph flow.
Fourth leading cause of death in USA for those aged 35-55yrs
Aetiology:
Unknown (~30%); alcoholic (~25-40%); HBV, HCV, HDV; hereditary metabolic diseases (eg haemochromatosis, Wilson’s disease); autoimmune (eg primary biliary cirrhosis, autoimmune hepatitis; SLE); drugs; biliary obstruction (eg cystic fibrosis, gallstones, tumour); diabetes mellitus; congestive heart failure
Pathogenesis:
Main processes are inflammation and necrosis of liver cells when liver is continuously exposed to toxins repair by fibrosis regeneration, fibrous scar, nodules distort surrounding tissues problems with blood flow
Clinical features:
Vary considerable from person to person, but includes hepatomegaly; haematosis (most common presentation); jaundice; ascites; cyanosis; purpura; easy bruising; portal hypertension; pigmentation; digital clubbing
Insidious onset
Treatment:
Irreversible; cessation of alcohol or hepatotoxic drugs will halt progression
Management of underlying cause.
Care of nutritional status
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