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Cirrhosis is a topic covered in the 5-Minute Emergency Consult.

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  • 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
  • 10th leading cause of death in US


  • Chronic alcohol abuse (most common cause in US)
  • Chronic viral hepatitis, B or C (2nd most common cause in US)
  • Autoimmune hepatitis
  • Biliary cirrhosis, primary (PBC) or secondary (sclerosing cholangitis)
  • 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:
    • Sarcoidosis
    • Amyloidosis
    • Nonalcoholic steatohepatitis (NASH)
    • 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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Rosen, Peter, et al., editors. "Cirrhosis." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307028/all/Cirrhosis.
Cirrhosis. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307028/all/Cirrhosis. Accessed April 26, 2019.
Cirrhosis. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307028/all/Cirrhosis
Cirrhosis [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 26]. 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
TY - ELEC T1 - Cirrhosis ID - 307028 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307028/all/Cirrhosis PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -