Cirrhosis

Etiology

  • Many different causes of chronic liver disease can lead to fibrosis, typically from decades of inflammation. Common causes include: alcohol, hepatitis C, hepatitis B, NASH.
  • Sometimes multiple chronic diseases (e.g. hep c + ETOH + fatty liver) can co-contribute to cirrhosis.
  • Less common causes include: PBC, PSC, Wilson's disease, autoimmune hepatitis, hemochromatosis.
  • An acute insult (e.g. ETOH, med toxicity) can also be superimposed on chronic cirrhosis to precipitate decompensation (ascites, confusion, other manifestations of liver failure).

Risk Factors

  • Chronic alcohol use, obesity, chronic use of meds that are hepatotoxic, chronic hepatitis C, chronic hepatitis B.

Symptoms

  • Often asymptomatic for years
  • Decompensation associated with: fatigue, jaundice, loss of muscle mass, development of ascites, peripheral edema, confusion (with encephalopathy), vomiting blood (with varices), darkening of urine

Physical Exam Findings

  • Jaundice, icterus
  • Ascites, lower extremity edema
  • Gynecomastia, spider angiomata, small testes (men)
  • Asterixsis (with encephalopathy)

Tests

Links