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Macronodular Cirrhosis


Presentation

  • Patients with hepatocellular carcinoma (HCC) presenting with nonmicronodular or micronodular cirrhosis are usually treated by hepatectomy.[ncbi.nlm.nih.gov]
  • Plus, this edition brings color to the book for more attractive and clearer presentation, and includes boxed elements to help readers summarize information.[books.google.de]
  • [Full text - PDF] ABSTRACT We present a case of left-sided intrathoracic ectopic liver with micro and macronodular cirrhosis.[new.medigraphic.com]
  • Confirm each diagnosis by consulting a section, organized by symptoms, that presents the full range of differential diagnoses and treatment options for each specific condition.[books.google.de]
  • Pruritus is reported when significant jaundice is present.[medical-dictionary.thefreedictionary.com]
Easy Bruising
  • Cirrhosis can lead to Easy bruising or bleeding, or nosebleeds Swelling of the abdomen or legs Extra sensitivity to medicines High blood pressure in the vein entering the liver Enlarged veins called varices in the esophagus and stomach.[icdlist.com]
  • Anorexia, early satiety, dyspepsia, altered bowel habits, and easy bruising and bleeding also are reported often.[medical-dictionary.thefreedictionary.com]
Weight Loss
  • Symptoms may not develop for years and are often nonspecific (eg, anorexia, fatigue, weight loss). Late manifestations include portal hypertension , ascites, and, when decompensation occurs, liver failure . Diagnosis often requires liver biopsy.[msdmanuals.com]
  • The symptoms of cirrhosis are the same regardless of the cause: nausea, fatigue, anorexia, weight loss, ascites, varicosities, and spider angiomas.[medical-dictionary.thefreedictionary.com]
  • Affected individuals can experience fatigue, weakness, loss of appetite, weight loss, nausea, swelling (edema), enlarged blood vessels, and yellowing of the skin and whites of the eyes (jaundice).People with cryptogenic cirrhosis may develop high blood[icdlist.com]
  • Weight loss, weakness, and osteoporosis are also common symptoms. As the condition advances, the patient is likely to experience hepatic failure, portal hypertension, and debilitation.[healthery.com]
  • Nonspecific Symptoms Fatigue, anorexia, and weight loss are common nonspecific symptoms of cirrhosis.[pathwaymedicine.org]
Non-Alcoholic Cirrhosis
  • […] due to cirrhosis Advanced cirrhosis Bacterial portal cirrhosis Capsular portal cirrhosis Cardiac cirrhosis Cardiac portal cirrhosis Cardituberculous cirrhosis Chronic hepatitis C with stage 3 fibrosis Chronic hepatitis c, stage 3 fibrosis Cirrhosis - non-alcoholic[icd9data.com]
Jaundice
  • Pruritus is reported when significant jaundice is present.[medical-dictionary.thefreedictionary.com]
  • […] everywhere he moves, they did tell him his liver was swollen 2 to 3 times it's normal size and that is where all the pain is coming from, he has no appitite, but he is not losing weight, not swelling in ankles, stomach is 3 times the size should be, and not jaundice[healthboards.com]
  • Kidney failure Jaundice Severe itching Gallstones A small number of people with cirrhosis get liver cancer. Your doctor will diagnose cirrhosis with blood tests, imaging tests, or a biopsy. Cirrhosis has many causes.[icdlist.com]
  • Structural changes in the liver may cause impairment of hepatic function manifested as: jaundice portal hypertension and varices ascites hepatorenal syndrome spontaneous bacterial peritonitis hepatic encephalopathy ultimately hepatic failure This definition[mergersdrugfil.com.ph]
Fetor Hepaticus
  • Fetor hepaticus. Palmar erythema. Terry's nails. Kayser-Fleischer rings. Tattoos. IV tract marks. What is the Child-Pugh scoring system for cirrhosis. It is used to predict the prognosis of cirrhotic patients.[brainscape.com]
  • This may be visible as an increase in abdominal girth. [15] Fetor hepaticus is a musty breath odor resulting from increased dimethyl sulfide . [16] Jaundice , or icterus is yellow discoloration of the skin and mucous membranes , (with the white of the[en.wikipedia.org]
Epistaxis
  • Epistaxis. Gynacomastia (in men). Xanthelasma/xanthoma. Dupuytren's contracture. Clubbing. Dilated chest/abdominal wall veins (caput medusae). Scratch marks. Parotid enlargement. Collateral vessels. Variceal bleeding. Encephalopathy.[brainscape.com]

Workup

Enlargement of the Spleen
  • Splenomegaly Increased pressure in the portal vein is conducted to the splenic vein resulting in congestive enlargement of the spleen. Over time this can cause symptoms of hypersplenism such as thrombocytopenia .[pathwaymedicine.org]
  • […] of the spleen, enlargement of the veins in the oesophagus (gullet) (which may rupture to cause severe bleeding), and accumulation of fluid in the peritoneal cavity (ascites).[flipper.diff.org]
  • Other liver findings suggestive of cirrhosis in imaging are an enlarged caudate lobe , widening of the fissures and enlargement of the spleen .[en.wikipedia.org]
Globulins Increased
  • Globulinsincreased due to shunting of bacterial antigens away from the liver to lymphoid tissue. Serum sodium – hyponatremia due to inability to excrete free water resulting from high levels of ADH and aldosterone .[en.wikipedia.org]
Albumin Decreased
  • : decreased in chronic liver diseases. prothrombin time: increased in acute and chronic liver diseases.[quizlet.com]
Total Protein Decreased
  • Protein metabolism tests show decreased total protein, decreased albumin, and increased globulin. Cholesterol levels are decreased as a result of abnormalities in fat metabolism. Prothrombin time is prolonged, and bilirubin metabolism is abnormal.[medical-dictionary.thefreedictionary.com]
Hepatocellular Carcinoma
  • Hepatocellular carcinoma is rare in infancy. This report describes the first documented case of congenital hepatocellular carcinoma associated with macronodular cirrhosis.[ncbi.nlm.nih.gov]
  • Patients with hepatocellular carcinoma (HCC) presenting with nonmicronodular or micronodular cirrhosis are usually treated by hepatectomy.[ncbi.nlm.nih.gov]
  • Keywords: Liver, angiogenesis, Cirrhosis, hepatocellular carcinoma, CD 34 How to cite this article: Amarapurkar AD, Vibhav, Kim V. Angiogenesis in liver cirrhosis and hepatocellular carcinoma.[ijpmonline.org]
  • Cirrhosis can be diagnosed with ultrasound, CT, and MRI, and these imaging modalities can also be used to evaluate for possible complications of cirrhosis, such as portal hypertension or hepatocellular carcinoma .[radiopaedia.org]
  • […] development of hepatocellular carcinoma (HCC).[jaocr.org]
Liver Biopsy
  • Forty-two patients with at least one liver biopsy strongly suggestive of ISC were selected for the study covering a period between 1968 and 1987.[ncbi.nlm.nih.gov]
  • Secondary biliary cirrhosis MRCP, ERCP, liver biopsy Primary sclerosing cholangitis MRCP, ERCP, liver biopsy Autoimmune Autoimmune hepatitis ANA, IgG level smooth muscle antibodies, liver-kidney microsomal antibodies, liver biopsy Vascular Cardiac cirrhosis[abdominalkey.com]
  • It is one of the patterns of cirrhosis of the liver that may be seen on liver biopsy. infantile cirrhosis Cirrhosis occurring in childhood as a result of protein malnutrition.[medical-dictionary.thefreedictionary.com]
  • Histology: Liver biopsy (punction): no signs of cirrhosis, large amount of brown pigment within hepatocytes. Patient 4 History: male, 36 years hereditary hemochromatosis (heterozygotic C282Y/H63D) Clinical signs: Admitted to perform liver biopsy.[atlases.muni.cz]
  • Diagnosis often requires liver biopsy. Cirrhosis is usually considered irreversible. Treatment is supportive. Resources In This Article[msdmanuals.com]

Treatment

  • Possible etiological factors for ISC were alcohol abuse, arsenic treatment, and hepatitis B infection. In three cases, a genetic factor could not be excluded.[ncbi.nlm.nih.gov]
  • Prednisone treatment tended to accelerate the conversion, but not significantly.[ncbi.nlm.nih.gov]
  • Review the latest developments in the field and get up-to-date clinical information on hot topics like polyps, capsule endoscopy, and pancreatic treatments.[books.google.de]
  • Surgical treatment was performed and ectopic liver was found between diaphragm and lung base. Location anomalies of liver tissue are rare entities. This case is an exceptional one because association of its location with cirrhosis.[new.medigraphic.com]

Prognosis

  • Prognosis: The classic teaching is that cirrhosis is irreversible; however, there is increasing evidence that it regresses. [3] [4] [5] Special types: Garland cirrhosis ( AKA holly leaf cirrhosis) - see primary biliary cirrhosis .[librepathology.org]
  • Treatment and prognosis depend on the correct assessment of these paramenters. CONTENTS[meddean.luc.edu]
  • THE CHILD -PUGH CLASSIFICATION SYSTEM The Child-Pugh classification is a scoring system used to determine the prognosis with cirrhosis.[flipper.diff.org]
  • It is used to predict the prognosis of cirrhotic patients. What areas does the Child-Pugh score take into consideration (5) Albumin. Bilirubin. INR. Ascites. Encephalopathy. What are the complications of cirrhosis. (9) 1.[brainscape.com]
  • "Assessment of Prognosis in Alcoholic Liver Disease: Can Serum Hyaluronate Replace Liver Biopsy?" European Journal of Gastroenterology and Hepatology 15 (September 2003): 941-944. Ristig, M., H. Drechsler, J. Crippin, et al.[medical-dictionary.thefreedictionary.com]

Etiology

  • Possible etiological factors for ISC were alcohol abuse, arsenic treatment, and hepatitis B infection. In three cases, a genetic factor could not be excluded.[ncbi.nlm.nih.gov]
  • See: alcoholism ; encephalopathy ; esophageal varix ; hepatic ; liver Etiology In the U.S., alcoholism and chronic viral hepatitis are the most common causes of the illness.[medical-dictionary.thefreedictionary.com]
  • Clinical records of the cirrhosis patients were summarized, and morphologic as well as etiologic classifications on liver cirrhosis were attempted. The morphologic and etiologic patterns characteristics in Korean were discussed in details.[jpatholtm.org]
  • Different cirrhotic etiologies tend to result in either micronodular, macronodular, or a mixed picture. Historically, this was used as a classification scheme for cirrhotic etiologies but has been put aside in recent years.[pathwaymedicine.org]
  • Most common etiologies include alcoholism, autoimmune chronic hepatitis and chronic viral hepatitis.[medtube.net]

Epidemiology

  • Etiologic classification: preferred This method of classification is the most useful clinically; by combining clinical, biochemical, histologic, and epidemiologic data, the likely etiologic agent can be ascertained The two most common causes of cirrhosis[mergersdrugfil.com.ph]
  • Epidemiology • According to World Health Organization (WHO) every year 34 million people are infected by Hepatitis C. About 150 million people are chronically infected and at risk of developing liver cirrhosis and/or liver cancer.[slideshare.net]
  • Journal of Clinical Epidemiology . 56 (1): 88–93. doi : 10.1016/S0895-4356(02)00531-0 . PMID 12589875 . Roguin A (2006). "Rene Theophile Hyacinthe Laënnec (1781–1826): The Man Behind the Stethoscope" .[en.wikipedia.org]
Sex distribution
Age distribution

Pathophysiology

  • […] cholangitis Chronic biliary obstruction Drug induced liver injury Cryptogenic (idiopathic) cirrhosis: accounts for 8 - 9% of liver transplants in the US; "burnt out" NAFLD / NASH is a common cause of cryptogenic cirrhosis ( Hepatology 2000;32:689 ) Pathophysiology[pathologyoutlines.com]
  • It is therefore important to understand the underlying pathophysiology of cirrhosis, as well as be able to concisely convey to clinicians important imaging findings, particularly those that would alter patient management.[jaocr.org]
  • […] may result in life-threatening variceal bleeding. de Im vorliegenden Beitrag werden neue Aspekte zur Pathophysiologie, der Therapie und der Prognose der Gallengangsatresie und der Choledochuszysten behandelt. en This article reviews new aspects of the pathophysiology[de.glosbe.com]
  • Pathophysiology of disease : an introduction to clinical medicine (6th ed.). New York: McGraw-Hill Medical. pp. Chapter 14: Liver Disease. Cirrhosis. ISBN 978-0071621670 . Iredale JP (2003).[en.wikipedia.org]
  • Galactosemia Glycogen storage disease type IV PATHOPHYSIOLOGY The liver plays a vital role in synthesis of proteins (e.g., albumin, clotting factors and complement), detoxification and storage (e.g., vitamin A).[flipper.diff.org]

Prevention

  • Prevention Eliminating alcohol abuse could prevent 75-80% of all cases of cirrhosis.[medical-dictionary.thefreedictionary.com]
  • Cirrhosis is irreversible in general, treatment is focused on prevention of complications and proceed normally. In advanced stages of cirrhosis, the only option is a liver transplant.[xelonet.com]
  • Treating the cause of cirrhosis prevents further damage; for example, giving oral antivirals such as entecavir and tenofovir in patients of cirrhosis due to Hepatitis B prevents progression of cirrhosis.[en.wikipedia.org]
  • Understanding the … Read More Risk Factor for Liver Disease Some liver diseases are potentially preventable and are associated with lifestyle choices.[mergersdrugfil.com.ph]
  • Cirrhosis: Diagnosis, Management, and Prevention ; American family physician By : S. PAUL STARR, MD, and DANIEL RAINES, MD, Louisiana State University Health Sciences Center School of Medicine at New Orleans, New Orleans, Louisiana 2.[slideshare.net]

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