Pathology and pathogenesis
Cirrhotic changes affect the whole liver, but not necessarily every lobule.
Micronodular cirrhosis (Laennec's cirrhosis).
Signs of hepatocellular failure
Features dominant in male cirrhotics
Signs of virilisation
Mechanisms of jaundice in cirrhosis are the following:
Conditions associated with spiders
White (Terry's) nails.
Parotid and lacrimal gland enlargement.
Portal hypertension, hepatic encephalopathy and renal failure.
Portal hypertension and its sequelae
Features of poor short-term prognosis in cirrhosis
1. Complete blood picture.
2. Liver function tests.
3. Prothrombin time.
4.Hepatitis B and C markers.
5.Blood ammonia estimation in cirrhosis is a reliable investigation, particularly in a situation where hepatic encephalopathy is suspected. The reasons for raised blood ammonia are:
6. Respiratory alkalosis.
7. Metabolic abnormalities.
8. Ultrasonographic examination.
9.Liver biopsy confirms the diagnosis of cirrhosis.
Treatment of underlying cause, removal of causative agents like drugs, alcohol, etc.