advertisement

Liver Cirrhosis

50 %
50 %
advertisement
Information about Liver Cirrhosis
Education

Published on March 6, 2009

Author: davejaymanriquez

Source: slideshare.net

Description

The disease Liver Cirrhosis, its definition, epidemiology, pathophysiology and anatomy, its medical and nursing management.
advertisement

Liver Cirrhosis Presented by: Dave Jay S. Manriquez RN.

 

Largest gland in the body 4 lobes Produced bile Contains bile salts, pigments, phospholipids, cholesterol and a variety of electrolytes

Largest gland in the body

4 lobes

Produced bile

Contains bile salts, pigments, phospholipids, cholesterol and a variety of electrolytes

Bilirubin Metabolism Blood Conjugated & Conjugated Urine – Urobilinogen Stool – Stercobilin

Blood

Conjugated & Conjugated

Urine – Urobilinogen

Stool – Stercobilin

Definition: Diffuse disorder of liver characterised by; Complete loss of normal architecture , Replaced by extensive fibrosis with, Regenerating parenchymal nodules .

Diffuse disorder of liver characterised by;

Complete loss of normal architecture ,

Replaced by extensive fibrosis with,

Regenerating parenchymal nodules .

A chronic progressive disease of the liver characterized by diffused damage to cells with fibrosis and nodular regeneration Repeated destruction of hepatic cells causes the formation of scar tissues

A chronic progressive disease of the liver characterized by diffused damage to cells with fibrosis and nodular regeneration

Repeated destruction of hepatic cells causes the formation of scar tissues

Introduction Cirrhosis is common end result of many chronic liver disorders. Diffuse scarring of liver – follows hepatocellular necrosis of hepatitis. Inflammation Loss of normal architecture & function.

Cirrhosis is common end result of many chronic liver disorders.

Diffuse scarring of liver – follows hepatocellular necrosis of hepatitis.

Inflammation

Loss of normal architecture & function.

Major types of Cirrhosis Laennec Cirrhosis Post necrotic Biliary Cardiac

Laennec Cirrhosis

Post necrotic

Biliary

Cardiac

Micronodular cirrhosis:

Alcoholic Hepatitis

Macronodular Cirrhosis

Nutmeg Liver-Cardiac Sclerosis

Prevalence of Liver Cirrhosis around the world

Normal Liver

Cirrhosis

Etiology of Cirrhosis Alcoholic liver disease 60-70% Viral hepatitis 10% Biliary disease 5-10% Primary hemochromatosis 5% Cryptogenic cirrhosis 10-15%

Alcoholic liver disease 60-70%

Viral hepatitis 10%

Biliary disease 5-10%

Primary hemochromatosis 5%

Cryptogenic cirrhosis 10-15%

Pathogenesis: Hepatocyte injury leading to necrosis. Alcohol, virus, drugs, toxins, genetic etc.. Chronic inflammation - (hepatitis). Bridging fibrosis. Regeneration of remaining hepatocytes Proliferate as round nodules. Loss of vascular arrangement results in regenerating hepatocytes ineffective.

Hepatocyte injury leading to necrosis.

Alcohol, virus, drugs, toxins, genetic etc..

Chronic inflammation - (hepatitis).

Bridging fibrosis.

Regeneration of remaining hepatocytes Proliferate as round nodules.

Loss of vascular arrangement results in regenerating hepatocytes ineffective.

Assessment Anorexia and wt. loss Early morning nausea and vomiting (with blood) Flatulence and changes in bowel habits Emaciation fatigue

Anorexia and wt. loss

Early morning nausea and vomiting (with blood)

Flatulence and changes in bowel habits

Emaciation

fatigue

Jaundice Abdominal pain and tenderness Ascites Peripheral edema

Jaundice

Abdominal pain and tenderness

Ascites

Peripheral edema

Dry skin and rashes Petechiae ecchymosis

Dry skin and rashes

Petechiae

ecchymosis

Spider angiomas (nose, cheeks, upper thorax and shoulders) Hepatomegaly Protruding umbilicus Dilated abdominal veins

Spider angiomas (nose, cheeks, upper thorax and shoulders)

Hepatomegaly

Protruding umbilicus

Dilated abdominal veins

Fector hepaticus Asterixis delirium

Fector hepaticus

Asterixis

delirium

Males (increase estrogen) Gynecomastia Impotence Fall of body hair Atrophy of testicles

Males (increase estrogen)

Gynecomastia

Impotence

Fall of body hair

Atrophy of testicles

Females (increase androgren) Hirsutism Acne Deepening of voice Increase virilism

Females (increase androgren)

Hirsutism

Acne

Deepening of voice

Increase virilism

Cirrhosis Clinical Features

Pathophysiology Alterations in blood and lymph flow Liver insult Alcoholic Ingestion, Viral hepatitis Exposure to toxins Hepatocyte damage liver Inflammation pain fever anorexia Nausea vomiting fatigue Increase wbc

Alterations in blood and lymph flow

Liver necrosis liver failure Liver fibrosis And scarring

Dec.androgen/ Estrogen p. Decrease ADH Dec.met.of CHON And Carb./ Dec.Fat bile Vit.k absop. hyperbilirubinemia Plasma CHON Bilirubin metabolism Bilirubin excretion In urine Clay-colored stool Dark urine jaundice Bleeding tendencies Spider angiomas Testicular atrophy Gyneco mastia Palmar Erythema Loss of Body hair Menstrual changes edema Hypoglycemia Acites Edema

Liver fibrosis Portal HPN ascites Anemia Thrombocytopenia leukopenia splenomegaly bleeding hemorrhoids Superficial Abdominal varices Esophageal varices edema infection Delayed Wound healing bleeding

Liver failure Inability to Metabolize ammonia Hepatic encephalopathy Confusion to Hepatic coma DEATH Increase serum ammonia Asterexis Respiratory acidosis Alterations In sleep Foul breath

Liver Biopsy – Cirrhosis

Liver Biopsy – Cirrhosis:

MRI Cirrhosis

Complications: Congestive splenomegaly. Bleeding varices. Hepatocellular failure. Hepatic encephalitis / hepatic coma. Hepatocellular carcinoma.

Congestive splenomegaly.

Bleeding varices.

Hepatocellular failure.

Hepatic encephalitis / hepatic coma.

Hepatocellular carcinoma.

Hepatocellular Carcinoma

Conclusions: Common end result of diffuse liver damage. (Viral hepatitis, Alcohol, congenital, drugs, toxins & Idiopathic) Characterised by diffuse loss of architecture. Fibrous bands & regenerating nodules distort and abstruct blood flow. (inefficient function) Hepatocellular insufficiency & portal hypertension. Shrunken, scarred liver, ascitis, spleenomegaly, liver failure, CNS toxicity.

Common end result of diffuse liver damage. (Viral hepatitis, Alcohol, congenital, drugs, toxins & Idiopathic)

Characterised by diffuse loss of architecture.

Fibrous bands & regenerating nodules distort and abstruct blood flow. (inefficient function)

Hepatocellular insufficiency & portal hypertension.

Shrunken, scarred liver, ascitis, spleenomegaly, liver failure, CNS toxicity.

Thank you and May God be Glorified

Resources Medical Surgical Nursing (Joyce M.Black, et.al) Pathology of Hepatitis & Cirrhosis Venkatesh Murthy Shashidhar Associate Professor of Pathology Fiji School of Medicine

Medical Surgical Nursing (Joyce M.Black, et.al)

Pathology of Hepatitis & Cirrhosis Venkatesh Murthy Shashidhar Associate Professor of Pathology Fiji School of Medicine

Add a comment

Related presentations

Related pages

Cirrhosis - Wikipedia, the free encyclopedia

Cirrhosis is a condition in which the liver does not function properly due to long-term damage. Typically, the disease comes on slowly over months or years.
Read more

Cirrhosis of the Liver Stages, Causes, Symptoms, Treatments

WebMD offers a comprehensive overview of cirrhosis of the liver, including types, causes, diagnosis, symptoms, and treatment.
Read more

Cirrhosis - National Institute of Diabetes and Digestive ...

Provides information about the causes, symptoms, diagnosis, complications, and treatment of cirrhosis. This publication is also available in Spanish.
Read more

Cirrhosis - National Library of Medicine - PubMed Health

Scarring and permanent injury to the liver, usually the result of chronic, long term damage. PubMed Health Glossary (Source: NIH - National Institute of ...
Read more

Cirrhosis of the Liver: Cirrhosis Signs and Stages

Learn about cirrhosis of the liver symptoms including jaundice, fatigue, weakness, loss of appetite, itching, and easy bruising.
Read more

Cirrhosis - NHS Choices - NHSChoices Home Page

Cirrhosis is scarring of the liver due to long-term liver damage. Find out what the signs and symptoms are, when to see your GP and how it can be treated ...
Read more

Cirrhosis of the Liver. Symptoms; Cirrhosis symptoms | Patient

Cirrhosis is a serious condition where normal liver tissue is replaced by scar tissue (fibrosis). It tends to progress slowly and often does not cause...
Read more

Cirrhosis: MedlinePlus - National Library of Medicine ...

Cirrhosis is scarring of the liver. Scar tissue forms because of injury or long-term disease. Scar tissue cannot do what healthy liver tissue ...
Read more

What I need to know about Cirrhosis - National Institute ...

Health Topics. Information about diabetes, digestive and liver diseases, kidney diseases, weight control and nutrition, urologic diseases ...
Read more

Cirrhosis - Mayo Clinic

Cirrhosis — Comprehensive overview covers symptoms, treatment of this life-threatening liver condition.
Read more