Liver Cirrhosis
Almost any chronic liver disease can lead to cirrhosis, a condition in which scar tissue forms in the liver and keeps it from functioning normally. In most cases, cirrhosis can be a result of chronic liver inflammation caused by excessive alcohol use or viral hepatitis. Other causes of cirrhosis include hemachromatosis. Wilson’s or alpha-1-antitrypsin deficiency. The following are also found to cause cirrhosis.
1. Primary biliary cirrhosis – tiny bile ducts in the liver inflame and scar for unknown reasons. Primary biliary cirrhosis occurs more often among women than men, generally between the ages of 35 and 60. Complications of the disease may include inflamed joints, osteoporosis from calcium loss, and sicca syndrome, a condition in which your tear glands and salivary glands fail to produce enough lubrication (King 2002).
2. Primary sclerosing cholangitis – in this condition, which may stem from autoimmune disorder, the walls of bile ducts inside and outside the liver thicken and harden. About 70 percent of people with the disease are men, and many of them also have inflammatory bowel disease (King 2002).
Anatomically. Fibrosis and widespread nodules in the liver characterize cirrhosis. Fibrosis is the deposition of scar tissue. Nodules form as dying cells are replaced by regenerating ones. Unfortunately, this regeneration results in an abnormal liver architecture. In early stages, the nodules and fibrosis may only be detected by microscopic examination of liver tissue obtained by biopsy. The patient may have no symptoms and live a normal, sometimes very active life. Ultimately, the fibrosis and nodule formation in cirrhosis cause distortion of the liver’s architecture, which interferes with blood flow through the organ. Cirrhosis can also lead to an inability of the liver to perform its major biochemical functions. As cirrhosis becomes more advanced, the abnormalities in the liver’s blood flow and biochemical functions lead to several potentially serious complications. These problems can lead to morbidity of the liver and the need for liver transplantation to survive (Worman 2002).
Signs of Cirrhosis
Signs that suggest the possible presence of cirrhosis include an enlarged spleen, ascites, and edema of the feet and legs. The liver size may be smaller than normal if it has shrunk from disease or large if the causative inflammation is still present. Jaundice is usually not present unless cirrhosis is in its terminal phase or inflammation is still present. Occasionally, bleeding from esophageal varices is the first sign that portal hypertension is present and may occur with little other evidence of cirrhosis. Encephalopathy may herald cirrhosis, but other signs are usually present. In long-established cirrhosis with portal hypertension, connections develop between the portal vein and the veins around the umbilicus (the “belly button”). These veins are the remnants of the umbilical vein, the vessel that supplied blood to the fetus from the mother. This connection allows blood to flow from the portal vein back to the heart by going around the scarred liver. These sometimes have the appearance of a mass of vessels and are called caput medusae, in reference to the mythological Greek character who had snakes for hair (Achord 2002).
References
Achord, J L 2002, Understanding Hepatitis, University Press of Mississippi, Jackson, MS.
King, J E (ed) 2002, Mayo Clinic on Digestive Health, Mason Crest, Philadelphia.
Worman, H J 2002, The Hepatitis C Sourcebook, McGraw-Hill Professional.
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