Liver Cirrhosis

In a nutshell

Cirrhosis replaces normal liver architecture with fibrous septa and regenerative nodules, causing failing synthetic function (coagulopathy, hypoalbuminaemia, jaundice) and portal hypertension (varices, ascites, splenomegaly) as its two core mechanisms. Decompensation is usually triggered by an identifiable precipitant.

Classic presentation

A patient with known chronic liver disease presenting with jaundice, ascites, confusion (encephalopathy) or a variceal bleed, often precipitated by infection, GI bleeding or constipation.

Key points

• 1Every complication of cirrhosis follows from either failing synthetic function or portal hypertension: map new findings onto one of these two mechanisms.