Cirrhosis Is A Late Stage of Scarring
Cirrhosis Is A Late Stage of Scarring
liver diseases and conditions, such as hepatitis and chronic alcoholism. The liver
carries out several necessary functions, including detoxifying harmful substances
in your body, cleaning your blood and making vital nutrients. Cirrhosis occurs in
response to damage to your liver. Each time your liver is injured, it tries to repair
itself. In the process, scar tissue forms. As cirrhosis progresses, more and more
scar tissue forms, making it difficult for the liver to function.
there is sufficient body of evidence suggesting that cirrhosis is a pathological
diagnosis with no laboratory cutoff values for the diagnosis of cirrhosis. However,
it can still be diagnosed clinically, by history, physical examination laboratory
analyses and ancillary testing such as ultrasonography. Early diagnosis has proven
to give relevantly better case management results while late detection can only
hardly manage the symptoms accompanied with cirrhosis
Screening for chronic liver disease is a key factor for early detection of signs for
liver damage, which can be performed inexpensively and easily with clinical
history-taking, measurement of transaminase concentrations, upper abdominal
ultrasonography, and transient elastography (where available). Abnormal findings
should prompt specific diagnostic testing to determine the etiology of the
underlying disease. In most patients, the dynamic process of progressive fibrosis,
which could ultimately lead to cirrhosis, can be interrupted by the timely
recognition of the risk, followed by appropriate treatment.
Cirrhosis isn't curable, but it’s treatable. Doctors have two main goals in treating
this disease: stop the damage to your liver, and prevent complications. Alcohol
abuse, hepatitis, and fatty liver disease are some of the main causes.
ETIOLOGY OF CIRRHOSIS Alcoholic liver disease and hepatitis C are the most
common causes in the Western world, while hepatitis B prevails in most parts of
Asia and subSaharan Africa. After the identification of the hepatitis C virus in 1989
and of nonalcoholic steatohepatitis (NASH) in obese and diabetic subjects, the
diagnosis of cirrhosis without an apparent cause (cryptogenic cirrhosis) is rarely
made.
Noninvasive
Abdominal ultrasonography with Doppler is a noninvasive, widely available modality that provides
valuable information regarding the gross appearance of the liver and blood flow in the portal and
hepatic veins in patients suspected to have cirrhosis. Ultrasonography should be the first radiographic
study performed in the evaluation of cirrhosis because it is the least expensive and does not pose a
radiation exposure risk or involve intravenous contrast with the potential for nephrotoxicity as does
computed tomography (CT). Nodularity, irregularity, increased echogenicity, and atrophy are
ultrasonographic hallmarks of cirrhosis.
Laboratory tests Laboratory-based methods for estimating the extent of hepatic fibrosis can be divided
into those based on routine liver function tests(26) and those based on particular laboratory values that
are associated with fibrosis, such as the hyaluronic acid concentration (27) . The AST-toplatelet ratio
index (APRI) is easily calculated as the quotient of the AST (GOT) and the platelet count and serves as a
screening index for advanced fibrosis and cirrhosis
Invasive
INVASIVE DIAGNOSIS OF CIRRHOSIS 1. CT AND MRI CT and magnetic resonance imaging (MRI) generally
are poor at detecting morphologic changes associated with early cirrhosis, but they can accurately
demonstrate nodularity and lobar atrophic and hypertrophic changes, as well as ascites and varices in
advanced disease. Although MRI sometimes differentiates among regenerating or dysplastic nodules
and hepatocellular carcinoma, it is best used as a follow-up study to determine whether lesions have
changed in appearance and size
2. Liver biopsy Referral for liver biopsy should be considered after a thorough, noninvasive serologic and
radiographic evaluation has failed to confirm a diagnosis of cirrhosis; the benefit of biopsy outweighs the
risk; and it is postulated that biopsy will have a favorable impact on the treatment of chronic liver
disease. The sensitivity and specificity for an accurate diagnosis of cirrhosis and its etiology range from
80 to 100 percent, depending on the number and size of the histologic samples and on the sampling
method