Chronic liver disease
| Incidental findings | Clubbing, tattoos |
| +ve signs | Icterus, dupuytren’s, scratch marks, spider naevi, gynaecomastia, ascites |
| Differential diagnosis | |
| Function | Compensated/decompensated: Hepatic flap, encephalopathy, ascites |
| Tests |
FBC – anaemia chronic disease LFTs including GGT Hep screen: viral serology, autoantibodies, iron+ferritin, AFP USS abdomen |
Causes
Alcohol
Viral hepatitis
Autoimmune: CAH, PBC
Metabolic: Haemochromatosis, Wilson’s, α1AT
Alcohol
Viral hepatitis
Autoimmune: CAH, PBC
Metabolic: Haemochromatosis, Wilson’s, α1AT
Notes
- Defined as diffuse liver abnormality characterized by fibrosis and abnormal regenerating nodules
- Other causes: R heart failure, constrictive pericarditis, budd-chiari, PSC, galactosaemia, storage disorders
- Complications cirrhosis: portalhypertension, variceal haemorrhage, heaptic encephalopathy, ascites, hepatorenal syndrome
- Precipitants hepatic encephalopathy: Infection, diuretics, Upper GI haemorrhage
- Management variceal bleeding: ABC, blood transfusion, endoscopy, octreotide if no rsponse then consider TIPPS