cirrhosis of liver

1. the name of God

2. cirrhosis
saeed
Renderer: •
adinehvand
Dr.
Respective Professor:
Eshratkhah

3. What is Cirrhosis?
• A chronic, progressive disease of the liver
• Extensive parenchymal cell degeneration &
Destruction of parenchymal cells
• Normal lobular structure distorted by fibrotic
connective tissue
• Lobules are irregular in size and shape with impaired
vascular flow

4. • This is the external surface of a normal liver. The color is brown and
the surface is smooth. A normal liver is about 1200 to 1600 grams.

5. Click on the portal triad and then on the central
vein in the section of liver below
• Liver is divided histologically into lobules. The center of the lobule is
the central vein. At the periphery of the lobule are portal triads.
Functionally, the liver can be divided into three zones, based upon
oxygen supply. Zone 1 encircles the portal tracts where the
oxygenated blood from hepatic arteries enters. Zone 3 is located
around central veins, where oxygenation is poor. Zone 2 is located
in between

6. What is the Function of the Liver?
• The liver extracts nutrients from the blood and
processes them for later use.
• The liver makes bile, which is used by the digestive
system to help absorb fat and certain vitamins.
• The liver also removes medications and toxic waste-
products from the blood and excretes them into bile.
• The liver is the body’s main factory for blood
proteins, including the proteins involved in normal
blood clotting function.

7. • Liver Biopsy – Cirrhosis

9. Etiology of Cirrhosis
• Alcoholic liver disease 40-45%
• Viral hepatitis & Post necrotic cirrhosis 20-25%
• Biliary disease 10-15%
• Cardiac cirrhosis 5%
• Primary hemochromatosis 5-10%
• Cryptogenic cirrhosis 10%
• Wilson’s, α1AT def rare

10. What are the Symptoms of Cirrhosis?
 Fatigue
 Itching
 Edema
 Ascites
 Digestive Tract Bleeding
 Jaundice
 hepatic encephalopathy

11. Etiology of Cirrhosis
• Alcoholic liver disease 40-45%
• Viral hepatitis & Post necrotic cirrhosis 20-25%
• Biliary disease 10-15%
• Cardiac cirrhosis 5%
• Primary hemochromatosis 5-10%
• Cryptogenic cirrhosis 10%
• Wilson’s, α1AT def rare

12. Alcoholic liver
• This is an example of a
micronodular cirrhosis.
The regenerative nodules
are quite small, averaging
less than 3 mm in size.
The most common cause
for this is chronic
alcoholism. The process
of cirrhosis develops over
many years.

13. Viral hepatitis
• Here is another example of macronodular cirrhosis.
Viral hepatitis (B or C) is the most common cause for
macronodular cirrhosis. Wilson's disease and alpha-1-
antitrypsin deficiency also can produce a
macronodular cirrhosis.

14. Post necrotic cirrhosis
• Ongoing liver damage with liver cell necrosis followed by
fibrosis and hepatocyte regeneration results in cirrhosis. This
produces a nodular, firm liver. The nodules seen here are
larger than 3 mm and, hence, this is an example of
"macronodular" cirrhosis

16. Biliary disease
• A close-up view of a micronodular cirrhosis in a liver with fatty
change demonstrates the small, yellow nodules. Micronodular
cirrhosis may also be seen with Wilson's disease, primary biliary
cirrhosis, and hemochromatosis.

17. Nutmeg Liver-cardiac cirrhosis
• In this liver observable two area
• 1.red area: the red area is ………..
• 2.pale area: the pale area is fibrotic.

18. Primary hemochromatosis

19. Cryptogenic cirrhosis

20. What are the Complications of Cirrhosis
•Ascites
•Varices
•Hepatic Encephalopathy
•Liver Cancer (Hepatocellular Carcinoma)
•spontaneous bacterial peritonitis

21. What Treatments for Cirrhosis are Available
•total avoidance of alcohol
•updating vaccinations
•Dietary salt restriction and diuretic
medications
•blood-pressure reducing medications
•TIPS shunt
•liver transplantation

22. References
•
• LIVER CIRRHOSIS, William Sanchez, M.D. & Jayant A. Talwalkar,
Miles and Shirley Fiterman, The American College of
Gastroenterology
• 6400 Goldsboro Rd., Suite 450, Bethesda, MD 20817
• P: 301-263-9000 F: 301-263-9025