Liver cirrhosis (Etiology symptoms, complications, treatment)

1. Big picture

Liver cirrhosis is the final common pathway of chronic liver injury. The liver becomes fibrotic, nodular, architecturally distorted, and functionally impaired.

For the final exam, cirrhosis is not only a histological diagnosis. Clinically, it means you must think in two directions:

Cirrhosis
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1. Portal hypertension → ascites, varices, splenomegaly, SBP, hepatorenal syndrome
2. Hepatic insufficiency → jaundice, coagulopathy, hypoalbuminemia, encephalopathy

The examiner usually wants you to answer:

1. What caused it? Alcohol, viral hepatitis, metabolic dysfunction-associated steatotic liver disease, autoimmune/cholestatic, metabolic/genetic.
2. Is it compensated or decompensated?
3. What complications are present? Ascites, variceal bleeding, encephalopathy, spontaneous bacterial peritonitis, hepatorenal syndrome, hepatocellular carcinoma.
4. How do you treat the cause and the complications?
5. When do you refer for liver transplantation?

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