Cirrhosis is the final result of all chronic hepatitis. The structure of the lobules in the liver is destroyed, separated by proliferating fibrous tissue surrounded by regenerating nodules, the intrahepatic circulation is impaired, and the parenchymal cells of the liver are reduced and decline in function.The main causes of cirrhosis are viral hepatitis and alcoholic hepatitis.
The pathomorphology can be divided into macronodular (caused by a virus), micronodular (caused by alcohol), and mixed types.And clinically it can be divided into asymptomatic compensated phase and compensated failure phase showing ascites and yellow bile, and in severe cases it goes into liver failure.
What are the symptoms of cirrhosis of the liver?
Like chronic hepatitis, cirrhosis has no obvious symptoms. In the early stage, there are only self-conscious symptoms such as tiredness and loss of appetite, so it is generally not understood when cirrhosis starts.This is in the compensated phase of cirrhosis. Once it enters the non-compensated phase, there will be subcutaneous varices, spider angiomas, palmar erythema, and abdominal swelling, and there will also be yellow bile.
1.Bleeding from a ruptured esophageal vein tumor
When swelling and ascites occur, the spleen is often enlarged and the white blood cells and platelets are reduced, which increases the risk of bleeding and eventually leads to the most serious complication, ruptured esophageal vein aneurysm. This is caused by a rise in portal pressure when the patient swallows hard food, coughs, or sneezes, resulting in bleeding.
2.Ascites & spontaneous peritonitis
Another complication is ascites, which is caused by an increase in portal pressure and a decrease in serum albumin. The increase in ascites not only makes the patient’s abdomen distended and uncomfortable but, most importantly, can produce life-threatening spontaneous peritonitis.
3.Liver coma
Another complication is hepatic coma, which is caused by the intense damage to the brain with the liver disorder, because the liver cells become rapidly necrotic, which significantly impairs the detoxification and metabolism of the liver, so that large amounts of toxic substances are absorbed from the intestinal and digestive tracts and travel to the brain with the bloodstream. Hepatic coma begins with a slight impairment of consciousness, with the patient speaking in strange languages, forgetfulness, day and night disruptions, strange behavior, and finally confusion, disorientation, and complete coma.
How is cirrhosis of the liver treated?
Cirrhosis can be considered the end of the line for liver disease, but if the compensated stage is properly maintained, daily life is still unaffected, but regular checkups, appropriate dietary therapy and quiet recuperation are required to prevent the deterioration of the disease.
1.Treatment of ascites
Once it enters the non-compensated phase, it must be treated aggressively.For example, if ascites is produced, the main thing is to throw diuretics and inject serum albumin to excrete the water in the abdominal cavity in the form of urine. If the effect is not good, we can only use a thick needle to penetrate the abdominal wall and excrete the ascites directly, or we can surgically bury a line to connect the abdominal cavity and the large blood vessels so that the ascites can enter the blood circulation to eliminate the ascites.
2.Treatment of ruptured esophageal venous tumor bleeding
In case of bleeding esophageal vein aneurysm, emergency endoscopic sclerotherapy or ligation of esophageal vein aneurysm can be performed, or compression with gastric and esophageal balloons to stop bleeding, along with special hemostatic medications; if treatment fails again, surgical resection of esophageal vein aneurysm and vascular splicing surgery can be performed.
3.Treatment of hepatic coma
In case of hepatic coma, it is necessary to try to reduce the concentration of the toxic substance, amonia, in the blood by preventing the production of amonia in the intestine and by promoting the detoxification metabolism of the liver. In the former case, antibiotics must be used to stop the intestinal bacteria from multiplying, while in the latter case, the patient can be given special amino acid preparations containing branch-locked amino acids.