Cirrhosis
Basics
Description
Description
- Progressive process of inflammation, cellular injury and necrosis, diffuse fibrosis, and formation of regenerative nodules
- Loss of lobular and vascular architecture
- Irreversible in advanced stages
- Intrahepatic portal hypertension owing to increased resistance at the sinusoid, compression of the central veins, and anastomosis between the arterial and portal systems
Etiology
Etiology
- Chronic viral hepatitis C (most common cause in the U.S.)
- Chronic alcohol abuse (second most common cause in the U.S.)
- Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH)
- Other: Chronic hepatitis B and/or D
- Metabolic:
- Hereditary hemochromatosis
- Wilson disease
- Porphyria
- Drugs:
- Acetaminophen
- Methotrexate
- Amiodarone
- Methyldopa
- Hepatic congestion:
- Right-sided heart failure
- Pericarditis
- Budd–Chiari syndrome (hepatic venous outflow obstruction)
- Infiltrative/autoimmune:
- Sarcoidosis
- Amyloidosis
- Primary biliary cholangitis (PBC) or secondary (sclerosing cholangitis)
- Hepatocellular carcinoma, diffusely infiltrating
- Infections:
- Brucellosis
- Echinococcosis
- Tertiary syphilis
- Schistosomiasis
Pediatric Considerations
- Congenital: Arteriohepatic dysplasia, biliary atresia
- Cystic fibrosis, α1-antitrypsin deficiency
- Metabolic
- Fructosemia, tyrosinemia, galactosemia, glycogen storage diseases
- Infectious
- Congenital hepatitis B
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Citation
Schaider, Jeffrey J., et al., editors. "Cirrhosis." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307028/all/Cirrhosis.
Cirrhosis. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307028/all/Cirrhosis. Accessed November 14, 2024.
Cirrhosis. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307028/all/Cirrhosis
Cirrhosis [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 November 14]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307028/all/Cirrhosis.
* Article titles in AMA citation format should be in sentence-case
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