Hepatic Cirrhosis

Definition:

Chronic condition of the hepatitis characterized by diffuse inflammation and fibrosis resulting in drastic structural changes & significant loss of liver function in which extensive degeneration & destruction of the liver parenchyma cells (Kuffer’s cells).

Major types of the Cirrhosis:

1. Laennecs Cirrhosis/ Portal Cirrhosis/ Nutritional Cirrhosis
2. Post-necrotic Cirrhosis
3. Billiary Cirrhosis
4. Cardiac Cirrhosis
5. Non-specific metabolic Cirrhosis

Clinical features:

1. GIT disturbance
2. Anorexia
3. Dyspepsia
4. Flatulence
5. Nausea/ vomiting
6. Fever
7. Lassitude
8. Weightlessness
9. Anemia

Complication:

1. Portal Hypertension
2. Peripheral edema
3. Ascites
4. Hepatic encephalopathy (coma)
5. Hepato-renal syndrome

Investigation:

1. Liver function studies
2. Asparate amino-transferase (AST)
3. Aluminates amino-transferase (ALT)
4. Alkaline phosphate
5. Serum Glutine pyruvic transferase (SGPT)
6. Y-glutamyl transferase
7. Liver Biopsy (Percutaneous needle)
8. Esophago-gastroduodeno scopy
9. Angiography
10. Liver scan
11. Serum electrolyte
12. Serum albumin
13. CBC
14. Stool for blood occult
15. Upper GI barium swallow

Medical management

1. No specific therapy, certain measures can be taken to promote Hepatic cells regeneration & prevent or treat complication

Surgical Management:

1. Hepatic Transplantation

Nursing Management:

1. Avoidance from alcohol or aspirin
2. Administration of B-complex
3. Complete bed rest
4. Advised for low fat diet
5. Hygienic care For Ascites:
6. Sodium restriction

For hepatic encephalopathy (Coma):

1. Sterilization of GI tract with antibiotics & levodopa is used
2. Monitor urine & stool for blood
3. Check vital sign at least every 4 hours
4. Take preventive measures for falling or injury to prevent complication of the bleeding.