Cirrhosis Hepatic

Cirrhosis hepatic is advanced phase of chronic liver disease in marked inflammatory process, liver cell necrosis, regeneration efforts and the addition of connective tissue (fibrosis) with the formation of nodules that interfere with the composition of the liver lobules

Etiology
• Hepatitis B, D and C
• Alcohol
• Metabolic (haemochromatosis, Wilson disease, nonalcoholic steato hepatitis, etc.)
• prolonged Kholestasis
• Obstruction of vena hepatica
• Autoimmune Disorders
• Toxins and drugs (methotrexate, aminodarone)
• Indian Childhood cirrhosis
• Cryptogenic

Morphology

Size of liver
• Normothropic cirrhosis
• Hypertropic cirrhosis
• Athropic cirrhosis

Size regeneration
• Granular
• nodular
• lobular cirrhosis
• Mixed nodular cirrhosis
• Smooth cirrhosis

The structure of liver tissue
• Multilobuler
• Monolobuler
• Pseudolobuler
• Case mix

Progressivity
• Progressive Forms
• Forms inactive

Formation
• Cirrhosis complete form
• Cirrhosis of the form incomplete

Clinical:
• liver Sirosih kompensata: on penterita not get a real symptoms and signs of liver cirrhosis
• Cirrhosis of the liver dekompensata: marks obtained in patients with liver cirrhosis a clear and present

Clinical manifestations of hepatitis serosis sourced from a failure that is fundamental:

• Symptoms or signs of liver failure:

1. Ikters
2. Spider naevi
3. Gynecomastia
4. Hipoalbumin and protein-calorie malnutrition
5. Underarm hair loss
6. Acites
7. Palmar erythema
8. White nail

• Symptoms or signs of hypertension, total:

1. Varicose esophagus / cardia
2. Splenomegaly
3. Dilation of collateral veins
4. Acites
5. Haemoroid
6. Caput medusa

To make a diagnosis is liver biopsy

Principles of therapy:

Diet rich in fiber and rich in proteins (except when there are complications encefalopati hepatic)

If there is swelling and acites
• Rest, reduced physical activity
• calorie-rich diet rich in protein, low salt
• Restriction of fluids (1 liter / day), especially when there hypernatremia

Complications that can be found:
• Hetemisis / melena due verises esophagus / cardia is broken
• Ensefalopatik hepatic
• Acites permagna
• Spontaneous bacterial peritonitis
• hepatorenal syndrome