Cirrhosis.ppt

Cirrhosis Jinliang Ni Dept. of Gastroenterology, the First Affiliated Hospital of Nanjing Medical University Outline: Definition Epidemiology Etiology Pathology and Pathophysiology Clinical Findings and Complications Diagnosis Treatment Prognosis Definition: End result of hepatocellular injury that leads to both fibrosis and nodular regeneration throughout the liver; A serious and irreversible disease ; Clinical features result from consequence of hepatic cell dysfunction, portosystemic shunting and portal hypertension. Epidemiology Incidence: 4.3%~14.2% of all inpatients Mortality: differ from districts and etiology Etiology——cause: Virus (Hepatic virus B~G,especially HBV,HCV) Alcohol nutrition: Alcoholism is common in west country. NASH(non alchoholic steatohepatitis), malnutrition Schistosoma (Schistosoma Japonica) Circulatory dysfunctions(especially right CHF) Metabolic derangements: copper,iron Cholestasis (over loading of bile) Autoimmune disorder: PBC Drugs,Anesthetics and environmental toxin Others 1.Viral hepatitis Virus :Hepatic virus B,C,D,F,G,CMV etc; HBV: afflicts nearly 400 million people worldwide HAV and HEV:not progress to cirrhosis 1.Viral hepatitis: Hepatitis B: the most common one in China Hepatitis C: the increasing cause of cirrhosis Liver cirrhosis seen with Naked Eye 1.Viral Hepatitis(Hepatitis C) 2.Alcoholic Hepatitis: 3.Schistosoma: Schistosoma Fibrosis of Liver: Characteristics: Hepatomegaly , splenomegaly is extremely obvious. Portal Hypertension is serious . Hepatocellular dysfunction is less common nor severe. 4.Circular Disorder: CHF(Congestive Heart Failure) Budd-Chiari syndrom: hepatic vein obstruction Obstruction of Inferior Vena Cava Other causes lead to congestions of liver Budd-Chiari syndrome Clotting of the hepatic vein, the major vein that leaves the liver The most common symptom in Budd-Chiari syndrome is ascites, or fluid accumulation in the abdomen The exam