emDocs - October 21, 2015 - By Long B - Edited by: Robertson J and Koyfman A
"Cirrhosis is the late stage of progressive hepatic fibrosis and is considered irreversible. In 2010, cirrhosis was the 8th leading cause of death in the U.S., and it most commonly due to Hepatitis C, followed by alcohol.1,2 Acute liver failure can also be due to drugs (most commonly acetaminophen), viral hepatitis, autoimmune, ischemia (shock liver), Wilson’s disease, and idiopathic (up to 14% of causes). Due to the many complications of cirrhosis, patient life expectancy is drastically reduced.
Major complications of cirrhosis include variceal hemorrhage, ascites, spontaneous bacterial peritonitis (SBP), hepatic encephalopathy, hepatorenal syndrome, and hepatopulmonary syndrome. If one of these develops, the patient is considered to have decompensated cirrhosis. Bleeding, infection, increased alcohol intake, dehydration, electrolyte abnormalities (hypokalemia specifically), and constipation can all ultimately contribute to the development of decompensated cirrhosis.
Pathologic changes in the liver lead to the above complications. These pathologic changes include fibrosis and the formation of regenerative nodules that replace normal hepatic tissue. This decreases hepatic venous flow and elevates portal pressures. This in turn causes splenomegaly, resulting in anemia, hypoalbuminemia, thrombocytopenia, and often ascites."
http://www.emdocs.net/approach-to-the-sick-cirrhotic-patient/