Post Hepatitis and Cryptogenic Cirrhosis Cardiac, Cirrhosis, Metabolic, Hereditary, Drug Related Cirrhosis

POST HEPATITIC AND CRYPTOGENIC CIRRHOSIS

  • Post hepatitis or post necrotic cirrhosis may follow any chronic liver disease.
  • Cryptogenic cirrhosis is cirrhosis of unknown etiol­ogy.

POST HEPATITIC Cirrhosis Etiology

  • · Cirrhosis may follow viral hepatitis B or C.
  • · It is especially common in high-risk groups ­multiple sexual partners, injection drug users, following blood transfusion.
  • · Non alcoholic fatty liver disease.
  • · Autoimmune hepatitis.
Chronic Hepatitis

Post Hepatitis and Cryptogenic Cirrhosis Cardiac, Cirrhosis, Metabolic, Hereditary, Drug Related Cirrhosis

POST HEPATITIC Cirrhosis Clinical features

  • · Signs and symptoms related to portal hyperten­sion and liver damage.

POST HEPATITIC Cirrhosis Treatment

  • Management of portal hypertension.
  • Treatment of primary disorders like Wilson’s dis­ease, hemachromatosis.

CARDIAC CIRRHOSIS

  • Prolonged, severe, right-sided congestive heart fail­ure leads to chronic liver injury and cardiac cirrhosis.
  • There may be reversible passive congestion of liver due to acute heart failure leading to chronic hepato­cellular necrosis, fibrosis, regenerative nodules and cirrhosis.

CARDIAC CIRRHOSIS Etiology

  • · Right sided ,heart failure as in mitral stenosis.
  • · Reduced car€Jiac output.
  • · Nutmeg liver is congestive liver with pale (fibrotic) areas.

CARDIAC CIRRHOSIS Clinical features

  • · Mild jaundice
  • · Liver dysfunction
  • · Hepatomegaly – firm, non tender
  • • *Ascites
  • · Peripheral edema
  • · Oesophageal bleeding
  • · Encephalopathy.

CARDIAC CIRRHOSIS Lab diagnosis

  • · Raised serum bilirubin
  • · Raised alkaline phosphatase
  • · Increased prothrombin time
  • · Increased AST.

CARDIAC CIRRHOSIS Treatment

  • Treat underlying cardiac disorder.

METABOLIC / HEREDITARY / DRUG RELATED CIRRHOSIS

  • The etiology, clinical features, and treatment depends on the underlying pathology.

NONCIRRHOTIC FIBROSIS OF LIVER Causes:

  • · Noncirrhotic portal hypertension (Indian child- hood cirrhosis)
  • · Banti’s syndrome
  • · Intrahepatic fibrosis
  • · Portal and splenic vein sclerosis
  • · Portal and splenic vein thrombosis
  • · Schistosomiasis (pipe-stem fibrosis)
  • · Congenital hepatic fibrosis associated with poly-
  • cystic disease of liver and kidney.
  • Indian childhood cirrhosis is a common cause of por­tal hypertension in India of unknown etiology.

NONCIRRHOTIC FIBROSIS Clinical features

  • · Clinical features are secondary to portal hyper­tension.
  • · There is no hepatocellular damage

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