Liver Cirrhosis…

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admin | Feb 21, 2010 | 0 comments
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The 10^th leading cause of death in the world wide is the chronic irreversible liver damage, characterized by replacement of normal liver tissue by fibrosis, scar tissue and regeneration of noramal liver tissue form nodules or lump in the liver leading to progressive loss of normal liver function.

Causes:

1. Alcohol abuse

2. Chronic hepatitis B ,C and D

3. Fatty liver

4. Cystic fibrosis

5. Glycogen storage disease

6. Alpha 1 antitrypsin deficiency deficiency

7. Chronic Bile Duct Blockage

8. Wilson’s Disease and Hemochromatosis

9. Drugs and Toxins

10. Autoimmune Hepatitis

Pathology :

The pathology of cirrhosis is formation of scar tissue that replaces normal liver parenchyma and blocking the portal blood flow. During scar formation normal parenchyma is damages that lead to activation of the stellate cell, formation of contractile myofroblast and obstructs blood flow. Additionally in cirrhosis there is disturbs the balance between matrix metalloproteinase and its inhibitors (TIMP 1 and 2) cause matrix breakdown and replacement by connective tissue-secreted matrix.

Finally entire liver is replaced by scar tissue.

Sign and symptoms:

Alopecia( hair loss)
The person may experience fatigue, weakness, and exhaustion. Loss of appetite is usual, often with nausea and weight loss.
Palmer erythema (Red palm)
Muscle wasting
Spidernavie ( Spider like blood vessels appear in the skin)
Parotid gland enlargement
Enlarge Men breasts( gynecomastia) and Testicular atrophy( shrunken testes)
Spleen enlarges
Fluid accumulate in the abdomen (ascite)

Diagnosis:

Diagnosis relies on history, physical examination, blood tests, ultrasound and CT scan and if still unable to diagnose Liver biopsy is needed.

Complication:

Portal hypertension and its consequence
Bleeding problem
Hepatic encephalopathy
Kidney failure
Diabetes
Increased risk of infections
Liver cancer

Treatment:

There is no cure for this disease but treatment of symptoms and sings and minimize the damage to liver cells and reduces complications.

Stop alcohol for alcoholic patient
Restricting salt and water
not to use unnecessary drugs
Use of diuretic
Decreasing dietary protein and using of laxatives
Antiviral drugs Like interferon
Steroid for autoimmune disease
Management of bleeding varices by injected sclerosing agents, banding, occasionally TIPPS and surgery is necessary to prevent bleeding.
Liver transplant is the standard treatment of selected patient.

Prognosis:

Cirrhosis is usually progressive even with medication and abstinence for alcohol can prolonged the life but who are having difficult abstaining alcohol, ascite and encephalopathy are dramatically impact a patient prognosis.

Conclusion:

Liver cirrhosis is a common problem world wide. Early diagnosis can be done to prevent complications .various treatment is available but there is no cure.

Ongoing medical research promise major advance in treating this disease in near future.

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