Insult to liver on long run can cause fibrosis of the liver and formation of nodules ,which is termed as liver cirrhosis. Liver cirrhosis is a chronic condition of the liver in which there is fibrosis and formation of nodules. The normal architecture of the liver gets distorted and patient presents with number of clinical feature.
Causes of Liver cirrhosis include:
1. Infection: Hepatitis B, C, D
2. Toxins: Alcohol
3. Cholestasis
4. Vascular
5. Metabolic
6. Genetic
7. Cryptogenic
CHILD-TURCOTTE-PUGH CLASSIFICATION OF CIRRHOSIS SEVERITY
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CHILD-TURCOTTE-PUGH CLASSIFICATION OF CIRRHOSIS SEVERITY |
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|
POINTS |
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| 1 | 2 | 3 | |
| ENCEPHALOPATHY | NONE | GRADE 1-2 | GRADE 3-4 |
| ASCITIS | NONE | MILD-MODERATE | SEVERE |
| BILIRUBIN (mg/dl) | <2 | 2-3 | >3 |
| ALBUMIN (g/dl) | > 3.5 | 2.8-3.5 | <2.8 |
| INR | <1.7 | 1.7- 2.3 | >2.3 |
| CLASS A | 5-6 POINTS (LEAST SEVERE) |
| CLASS B | 7-9 POINTS (MODERATE SEVERE) |
| CLASS C | 10-15 POINTS (MOST SEVERE) |
The rough diagram provided below will helps us memorizing all the major features of hepatic cirrhosis.
1. Hepatic encephalopathy
2. Jaundice
3. Epistaxis
4. Fetor hepaticus
5. Pigmentation
6. Purpura
7. Clubbing
8. Hepatomegaly
9. Splenomegaly
10. Ascites
11. Loss of libido
12. Impotence
13. Testis atrophy
14. Collateral vessels
15. Menstrual irregularities
16. Amenorrhea
17. Menorrhagia
18. Palmar erythema
19. Gynaecomastia
20. Breast atrophy
21. Spider telangiectasia
22. Cyanosis
23. Hair loss
24. Fever
DIAGNOSIS AND MANAGEMENT: PART 2
Dr Bivek Singh
Academic coordinator (MBBS)
Author “A journey into the human body”
Author “Pharmacology Simplified”
Board of Directors (Medical Outreach Nepal, USA)