Cirrhosis resident survival guide

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Twinkle Singh, M.B.B.S. [2]


Cirrhosis is the final stage of chronic liver disease, characterized by replacement of normal liver architecture with fibrosis (scar tissue) and regenerative nodules.


Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes


Shown below is an algorithm summarizing the approach to [[Cirrhosis]].

Initial Work Up for Cirhosis

History of jaundice, pruritis, weakness, abdominal distention, confusion, upper GI bleed
Signs of liver failure on examination
Send ivestigations, CBC, LFTs, serum chemistry, abdominal USG
Liver biopsy for definitive diagnosis (not required if clinical, laboratory and radiology data suggest cirrhosis)

Further Management of Cirrhosis after Diagnosis

Patient diagnosed with cirrhosis
MELD score
Consider referring patient to a transplant center
De-compensated cirrhosis (with complications)
Compensated cirrhosis (complications)
Slower disease progression
Alcohol abstinence, antiviral treatment for hepatitis related cirrhosis, avoidance of hepatotoxic agents, vaccination against Hep A and Hep B
Hepatorenal Syndrome
Hepatic encelopathy


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