Overview

• The pathological end-stage of any chronic liver disease, characterised by fibrosis and conversion of normal liver architecture to structurally abnormal nodules known as regenerative nodules
• M>F (2:1)
• Most Common Causes → Viral Hepatitis B & C, alcohol-related liver disease, and non-alcoholic fatty liver disease
• Amboss Overview

Making Diagnosis

Clinical Features:

• Abdominal Distension → symptom of decompensated cirrhosis secondary to ascites in portal hypertension
• Jaundice and Pruritus → suggests decompensated cirrhosis secondary to reduced hepatic excretion of conjugated bilirubin
• Encephalopathy → due to excess ammonia. May lead to confusion, altered GCS, asterixis.
• Blood in Vomit (Haematemesis) and Black Stool (Melaena) → suggests decompensated cirrhosis secondary to GI haemorrhage (varices)
• Hand and Nail features → Leukonychia (Hypoalbuminaemia), Palmar Erythema, Clubbing, Dupuytren Contracture (alcohol-related liver disease)
• Spider Naevi (>4, fill from centre) and Gynaecomastia
• Hepatomegaly & Splenomegaly

Portal Hypertension ⇒ ascites, splenomegaly, caput madusae. Causes swelling of veins (varices) in oesophagus and rectum.

<aside> 💡 A to J of Liver Failure ⇒ asterixis, bruising, clubbing, dupuytren’s contracture, erythema (palmar), fetor hepaticus, gynaecomastia, hepatomegaly, itching, jaundice

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