End result of liver injury and is often seen as chronic

Can lead to nodule formation and fibrosis

Serious and generally unable to reverse. One of the top leading causes of death in the US about 1-2% of all deaths.

Divided into micronodular, macronodular, and mixed forms

Causes the liver to loose its function such as:  metabolism of nutrients, bile production, and detoxification of blood along with other functions.

It is often a one way direction and not reversible

Clinical features include:
   -  Hepatic cell disfunction
   -  Portosystemic shunting
   -  Portal hypertension

Causes of Cirrhosis:
   -  Alcoholic liver disease
   -  Hepatitis C
   -  Hepatitis B
   -  Autoimmune Hepatitis
   -  Primary and Secondary Bilary Cirrhosis
   -  Primary Sclerosing Cholangitis
   -  Alpha 1-Antitypsin Deficiency
   -  Wilson’s Disease
   -  Hemochromatosis
   -  Drug induced liver disease
   -  Many others

Symptoms:
   -  Weakness
   -  Fatigue
   -  Weight loss
   -  Nausea
   -  Abdominal pain
   -  Enlarged liver (70%)
   -  Enlarged spleen fever
   -  Ascites
   -  and others.

Varices are common with portal hypertension

Doppler studies, CT, MRI, liver biopsy may be appropriate.

Treatment:

   -  Stop consuming alcohol

   -  Diet change

   -  Loss of weight

   -  Diuretic: Spironolactone

   -  Paracentesis

   -  Transjugular intrahepatic portosystemic shunt (TIPS) – for variceal bleeding that has no improvement with tradition means (endoscopic band ligation or sclerotherapy)

   -  Antibiotics when necessary

   -  Liver Transplant