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Definition:Diffuse liver disease characterized by degeneration, fibrosis, regeneration
nodules, and loss of architecture
1. Chronic Viral Hepatitis: HCV or HBV.
2. Alcoholic Steato-Hepatits (ASH)
3. Non-Alcoholic Steato-Hepatitis (NASH).
4. Auto-Immune Hepatitis.
5. Biliary cirrhosis.
6. Cardiac cirrhosis.
7. Hemochromatosis.
8. Wilson’s disease.
9. Rare causes:
Alpha 1 anti-trypsin deficiency.
Drugs & toxins: methotrexate & isoniazide.
N.B.: Hepatic schistosomiasis is a mere fibrosis of the liver and not
cirrhosis, as there is no degeneration, regeneration nodules or loss of architecture.
Complications of liver cirrhosis:
1. Liver failure.
2. Portal hypertension.
3. Hepatocellular carcinoma.
Clinical Picture:
A. Latent Cirrhosis (Compensated):
Early in the disease there is no impairment of liver functions.
The patient is discovered accidentally.
An enlarged liver and may be an enlarged spleen are found during examination or imaging
of the patient for a non-related condition.
B. Manifest Cirrhosis (Decompensated):
Late in the disease there will be:
1. Features of hepatocellular failure: (general failure of health, low grade fever, fetor
hepaticus, hepatocellular jaundice, ascites & edema)
2. Features of portal hypertension :( splenomegaly, ascites, varices )
3. Shrunken liver and splenomegaly.
* Hepatocellular carcinoma (HCC) may occur.
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