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Pathology
Irreversible liver fibrosis with liver architecture disrupted by regenerative nodules, caused by persistent insults to the liver from a number of causes
Aetiology
Alcohol, non-alcoholic steatohepatitis, Haemochromatosis, Wilson’s disease, alpha-1 antitrypsin deficiency, autoimmune hepatitis, PBC, PSC, Hepatitis C, idiopathic
Signs
Spider naevi, ascites, peripheral oedema, jaundice, asterixis, caput medusae, splenomegaly
Symptoms
Ascites
Investigations
Bloods: FBC – macrocytic anaemia suggests alcohol
Imaging: Ultrasound Abdomen shows irregular small liver and splenomegaly
OGD: May show the presence of varices
Treatment
Ascites: Diuretics (Furosemide and Spironolactone)
Hepatic Encephalopathy: Lactulose and Rifaximin
Prognosis
Child-Pugh Score assesses severity of liver disease by taking into account ascites, extent of jaundice, albumin, INR and presence of encephalopathy
The three cardinal signs of decompensated cirrhotic lever disease are
encephalopathy, fluid retention (ascites/oedema) and jaundice
Key Facts
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Key Images
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Key References
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