Chronic Liver Disease (CLD) / Cirrhosis- Causes , Symptoms, Treatment

August 14, 2012 | By | Reply More

Chronic Liver Disease (CLD) / Cirrhosis- Causes , Symptoms, Treatment

Causes of CLD (chronic liver disease)

1.Chronic hepatitis B&C
2.Alcoholic hepatitis
3.NAFLD (non alcoholic fatty liver disease)
4.Auto immune:

  • Auto immune hepatitis,
  • primary billary cirrhosis,
  • primary sclerosing cholangitis,

5.Genetic:

  • Willsons disease,
  • primary heamochromatosis,
  • α1 antitrypsin deficiency

6.Idiopathic
7.Drugs:

  • methotrexet

8.Cardiac cirrhosis

Features of CLD/ cirrhosis

1.Jaundice
2.Ascites
3.Hepatomegaly
4.Features of portal hypertension:

  • splenomegaly,
  • collateral vassels,
  • ascites

5.Features of hepatic  failure/ hepatic encephalopathy:

  • flepping tremor,
  • planter extension,
  • constructional apraxia,
  • fetor  hepaticus

6.Circulatory changes:

  • spider telangiectasia,
  • plamer erythoma,
  • cyanosis

7.Bleeding tendency:

  • purpura,
  • bruises,
  • epistaxis

8.Endocrine changes:

  • loss of libido,
  • loss of hair,
  • male- gynocomasia, testicular atrophy,
  • female- brest atrophy

9.Others:

  • pigmentation,
  • digital clubbing

Complication of cirrhosis:

  1. Features of portal hypertension: gastro esophageal varices,  portal hypertensive gastropathy, splenomegaly, ascitis
  2. Hepatic encephalopathy: flepping tremor, planter extension, constructional apraxia, fetor  hepaticus
  3. Porto pulmonary HTN
  4. Hepato pulmonary syndrome
  5. Hepato renal syndrome
  6. Coagulopathy
  7. Haematologic abnormalities: anaemia, neutropenia, thrombocytopenia
  8. Bone disease: osteopenia, osteomalacia, osteoporosis
  9. Malnutrition
  10. Sub acute bacterial peritonitis

Investigation:

  1. Liver function test
  2. Viral marker: HBsAg, anti HCV
  3. USG of whole abdomen
  4. Endoscopy of upper GIT
  5. Routine exam

Treatment:

  1. Bed rest- absolute rest in decompensate stage
  2. Diet- salt free high protein diet
  3. Treatment of complication
  4. Treatment of etiology, if possible
  5. Specific treatment- liver transplantation

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Category: Medical, Medicine

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