Cirrhosis

Cirrhosis is the pathologic end-stage of any chronic liver disease and most commonly results from chronic hepatitis B and C, alcohol-related liver disease, and nonalcoholic fatty liver disease.

The main complications of cirrhosis are related to the development of liver insufficiency and portal hypertension and include ascites, variceal hemorrhage, jaundice, portosystemic encephalopathy, acute kidney injury and hepatopulmonary syndromes, and the development of hepatocellular carcinoma.

Once a patient with cirrhosis develops signs of decompensation, survival is significantly impaired.

Management of cirrhosis includes treating underlying liver disease, avoiding superimposed injury, and managing complications. Timely referral for liver transplantation may be the only curative treatment option for patients with decompensated cirrhosis.

Chronic liver disease and cirrhosis are significant causes of premature mortality.

Cirrhosis is a diffuse pathologic process, characterized by fibrosis and conversion of normal liver architecture to structurally abnormal nodules known as regenerative nodules.[1]Anthony PP, Ishak KG, Nayak NC, et al. The morphology of cirrhosis: definition, nomenclature, and classification. Bull World Health Organ. 1977;55(4):521-40. http://www.ncbi.nlm.nih.gov/pubmed/304393?tool=bestpractice.com

It can arise from a variety of causes and is the final stage of any chronic liver disease. It can lead to portal hypertension, liver failure, and hepatocellular carcinoma. In general, it is considered to be irreversible in its advanced stages, although there can be significant recovery if the underlying cause is treated.[Figure caption and citation for the preceding image starts]: Laparoscopic view of a cirrhotic liverCourtesy of Dr Eugene Schiff and Dr Lennox Jeffers; used with permission [Citation ends].