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Liver cirrhosis
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Liver cirrhosis

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Contributors: Michael W. Winter MD, Paritosh Prasad MD
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Synopsis

Liver cirrhosis : Fatigue, Jaundice, Abdominal distension, Mental status alteration, Anorexia, Peripheral leg edema, Pruritus
Cirrhosis is fibrosis of the liver, which occurs in end-stage liver disease. It is thought to be a mostly irreversible process. Cirrhosis is characterized by impairment in liver function leading to portal hypertension and potential decompensated cirrhosis hallmarked by ascites development with risk for spontaneous bacterial peritonitis, hepatic encephalopathy, variceal formation and bleeding, hepatorenal syndrome, and hepatocellular carcinoma. All of these decompensating events contribute to a high mortality from cirrhosis and a greatly diminished life expectancy for patients with cirrhosis who do not receive a liver transplant. Cirrhosis is very common in the United States and is a major source of health care expenditures, with indirect and direct costs totaling an estimated $12 billion annually.

Patients with cirrhosis also have an increased risk of infectious complications including urinary tract infection, pneumonia, spontaneous bacteremia, skin and soft tissue infections (eg, Staphylococcus aureus), candidiasis, Clostridioides difficile infection, cholangitis, tuberculosis, and hemochromatosis.

The most common etiologies of cirrhosis are chronic viral hepatitis B and hepatitis C, nonalcoholic steatohepatitis, and alcoholic liver disease. Some patients with cirrhosis have physical examination findings such as jaundice, spider angiomata, palmar erythema, caput medusa, a firm and enlarged liver, or ascites. However, many patients with cirrhosis will have no physical examination findings.  

Cirrhosis is a progressive condition that greatly decreases life expectancy. Due to its irreversibility, patients either receive a liver transplant or are at high risk to develop a decompensating event, which carries high mortality.

Codes

ICD10CM:
K74.60 – Unspecified cirrhosis of liver

SNOMEDCT:
19943007 – Cirrhosis of liver

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Etiologies of cirrhosis:

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed:03/19/2018
Last Updated:06/29/2021
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Liver cirrhosis
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A medical illustration showing key findings of Liver cirrhosis : Fatigue, Jaundice, Abdominal distension, Mental status alteration, Anorexia, Peripheral leg edema, Pruritus
Clinical image of Liver cirrhosis - imageId=967922. Click to open in gallery. caption: 'Fingernails with white opacity of the entire nail beds except for the distal 1- to 2-mm pink band.'
Fingernails with white opacity of the entire nail beds except for the distal 1- to 2-mm pink band.

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