project

3. Normal Liver •Cirrhosis

4. Definition:
1. Diffuse disorder of liver characterised
by;
2. Complete loss of normal architecture,
3. Replaced by extensive fibrosis with,
4. Regenerating parenchymal nodules.

5. A chronic progressive disease of the liver
characterized by diffused damage to cells
with fibrosis and nodular regeneration
Repeated destruction of hepatic cells
causes the formation of scar tissues

6. Introduction
Cirrhosis is common end result of many
chronic liver disorders.
Diffuse scarring of liver – follows
hepatocellular necrosis of hepatitis.
Inflammation
Loss of normal architecture & function.

7. Major types of Cirrhosis
Laennec Cirrhosis
Post necrotic
Biliary
Cardiac

8. Etiology of Cirrhosis
Alcoholic liver disease 60-70%
Viral hepatitis 10%
Biliary disease 5-10%
Primary hemochromatosis 5%
Cryptogenic cirrhosis 10-15%

9. Pathogenesis:
Hepatocyte injury leading to necrosis.
 Alcohol, virus, drugs, toxins, genetic etc..
Chronic inflammation - (hepatitis).
Bridging fibrosis.
Regeneration of remaining hepatocytes
Proliferate as round nodules.
Loss of vascular arrangement results in
regenerating hepatocytes ineffective.

10. Assessment
Anorexia and wt. loss
Early morning nausea and vomiting (with
blood)
Flatulence and changes in bowel habits
Emaciation
fatigue

11. Cirrhosis
Clinical
Features

12. Pathophysiology
Liver insult
Alcoholic Ingestion, Viral hepatitis
Exposure to toxins
Hepatocyte
damage
Alterations in
blood and
lymph flow
liver
Inflammation
pain
fever
anorexiaNausea
vomiting
fatigue
Increase
wbc

13. Liver
necrosis
liverliver
failurefailure
Liver fibrosisLiver fibrosis
And scarringAnd scarring

14. Dec.androgen/
Estrogen p.
Decrease ADH
Dec.met.of CHON
And Carb./
Dec.Fat
bile
Vit.k absop.
hyperbilirubinemia
Plasma
CHON
Bilirubin metabolism
Bilirubin excretion
In urine
Clay-colored
stool
Dark urine
jaundice
Bleeding
tendencies
Spider
angiomas
Testicular
atrophy
Gyneco
mastia
Palmar
Erythema
Loss of
Body hair
Menstrual
changes
edema
Hypoglycemia Acites
Edema

15. Liver fibrosisLiver fibrosis Portal HPN
ascites
Anemia
Thrombocytopenia
leukopenia
splenomegaly
bleeding
hemorrhoids
Superficial
Abdominal
varices
Esophageal
varices
edema
infection
Delayed
Wound
healing
bleeding

16. Liver failureLiver failure
Inability to
Metabolize
ammonia
Hepatic
encephalopathy
Confusion to
Hepatic
coma
DEATHDEATH
Increase
serum
ammonia
Asterexis
Respiratory
acidosis
Alterations
In
sleep
Foul breath

17. Liver Biopsy – Cirrhosis

18. Liver Biopsy – Cirrhosis:

19. MRI Cirrhosis

20. Complications:
Congestive splenomegaly.
Bleeding varices.
Hepatocellular failure.
 Hepatic encephalitis / hepatic coma.
Hepatocellular carcinoma.

21. Conclusions:
Common end result of diffuse liver damage.
(Viral hepatitis, Alcohol, congenital, drugs, toxins & Idiopathic)
Characterised by diffuse loss of architecture.
Fibrous bands & regenerating nodules distort
and abstruct blood flow. (inefficient function)
Hepatocellular insufficiency & portal
hypertension.
Shrunken, scarred liver, ascitis,
spleenomegaly, liver failure, CNS toxicity.

22. Thank you andThank you and
May God beMay God be
GlorifiedGlorified