Hepatic Cirrhosis

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
Etiology:
Laennecs Cirrhosis/ Portal Cirrhosis/ Nutritional Cirrhosis due to the excessive alcohol
due to the viral toxic
Billiary Cirrhosis due to the bile obstruction
due to the right sided heart failure
due to the metabolic or infectious disease

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.

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