Cirrhosis, Portal hypertension and Varices Flashcards
What is cirrhosis?
Development of fibrosis and loss of lobular organisation in response to chronic liver injury.
Can lead to portal hypertension and end stage liver disease.
May affect liver cell function.
What is the most common cause of liver cirrhosis?
Alcohol
What does cirrhosis of the liver cause?
- Decreased removal and conjugation of bilirubin
*Decreased production of bile
*Decreased removal of toxins such as drugs
*Decreased production of blood clotting factors
and plasma proteins
*Impaired digestion and absorption of nutrients
particularly fats
What is portal hypertension?
High blood pressure in the portal vein that runs through your liver.
What does portal hypertension cause?
Portal hypertension causes an increase in the pressure of blood in the gastric veins which can lead to the formation of oesophageal varices which can haemorrhage and be life
threatening.
What causes jaundice?
Back up of bile in the liver, elevated bilirubin levels in the blood cause jaundice.
What causes portal hypertension?
Blockage of blood to the liver
What is splenomegaly?
Enlargement of the spleen
What causes splenomegaly?
Congestion of bile in the spleen.
What are the three steps ion how cirrhosis occurs?
- Accumulation of fat in the liver cells.
- Inflammation and necrosis occur and fibrous tissue forms.
- Basic structure of the liver is significantly altered and little function remains.
What are oesophageal varicose and why are the bad?
They are distended veins (varices) near the mucosal surface of the Oesophagus.
A result of portal hypertension.
They are bad because they can easily haemorrhage which can be life threatening.
What is the clinical presentation of oesophageal varices?
Haematemesis/Malaena
Abdo pain
Confusion secondary
Signs of shock
May have history of chronic liver disease
What is the epidemiology of oesophageal varices?
Responsible for 5-11% of upper GI bleeding.
