Cirrhosis
• Cirrhosis is a chronic condition characterized by diffuse replacement of liver cells by fibrotic tissue, which creates a nodular-appearing distortion of the normal liver architecture.
Advanced fibrosis represents the end result of many etiologies of liver injury.• Cirrhosis affects nearly 5.5 million Americans. In 2009, it was the 12th leading cause of death in the US.30
• The most common etiologies are alcohol-related liver disease, chronic viral infection, and NAFLD (diagnosis and treatment discussed earlier in respective sections).
• Main complications of cirrhosis include portal hypertension with various clinical manifestations (ascites, esophageal and gastric varices, portal hypertensive gastropathy (PHG) and colopathy, hypersplenism, gastric antral vascular ectasia, spontaneous bacterial peritonitis [SBP], hepatorenal syndrome [HRS], hepatic encephalopathy, and HCC). Frequent laboratory abnormalities encountered in a patient with cirrhosis include anemia, leukopenia, thrombocytopenia, hypoalbuminemia, coagulopathy, and hyperbilirubinemia.