Cirrhosis

cirrhosis hepatic is one chronic disease liver in which architecture is upset in a way diffuse and irreversible by one necroses hépatocytes, followed lesions of fibrosis alternating with beaches of cellular regeneration which do not respect any more the initial organization lobulaire.

These zones of regeneration are called "nodules of regeneration". The cirrhosis is the consequence of aggression hépatocytaires prolonguées, , , or others (, enzymatic deficit, , etc.).

Synopsis 1 Symptoms 1.1 Initial symptoms 1.2 Complications 2 Etiology 3 Diagnosis 3.1 Pathological anatomy 3.2 Methods of hepatic biopsy 4 Pathology 5 Physiopathology 6 Treatment 7 Epidemiology 8 Consequences and complications 9 Comment 10 References

Symptoms

Initial symptoms

Complications

Etiology

• Viral hepatites especially B, (D) and C, in their chronic form
• Disease genetics (primitive biliary cirrhosis, , déficite hereditary in alpha-1 antitrypsin...)
• Disease car-immune
• Hémochromatose
• Galactosemy
• Disease of glycogen overload

Diagnosis

The diagnosis of cirrhosis is based on the whole of the clinical and biological arguments found at a patient. The diagnostic one of certainty is posed on the hepatic fabric biopsy. The hepatic biopsy is not inevitably necessary to evoke diagnoses it alcoholic cirrhosis, but will be generally carried out for the other causes of cirrhosis.

Pathological anatomy

of the cirrhosis shows:

• nodules of regeneration
• a diffuse tissue fibrosis.

The liver can be atrophied or conversely hypertrophied according to the prevalence of lesions of destruction or regenerations.

Other lesions are visible, they are characteristic of the mechanisms or etiologies in the beginning of the cirrhosis.

• Alcoholic cirrhosis:
  • the hepatic steatosis macrovésiculaire,
  • signs of ignition with an infiltration of and of
  • bodies of Mallory
  • a cytolysis
  • giant
  • hépatosidérose

• Disease of Wilson:
  • copper deposits in the hépatocytes

• Hémochromatose:
  • Hepatic iron in high concentration
  • Deposits of hémosidérine

• Primitive biliary cirrhosis:
  • modification of través of the bile ducts.

Methods of hepatic biopsy

• Trans-chin-strap sees
• Trans-parietal way (between the coasts)
• Laporoscopic biopsy

These techniques present difficulties and advantages suitable for chacunes.

Use of colourings éosine-saffron, trichromatic of Masson, Perls and the STEP

Proportioning of the iron weight and search for viral antigens.

Pathology

Physiopathology

Treatment

Epidemiology

Consequences and complications

• Hepatic insufficiency
• Digestive haemorrhages especially oesophagiennes
• Cancer of the liver (hepatocarcinomist)

Comment

In a rather systematic way one connects a cirrhosis to an alcoholism. However, that is not always the case. Nevertheless, alcoholism is the principal cause of cirrhosis. the 2nd consequence of the cirrhosis after the hepatic insufficiency is the hypertention portale which it is has the origin of the digestive hemorragies.

References

Care of health - -

Diseases of -

Halitose - Nausea - - Backward flow gastro-?sophagien - Achalasy - Cancer of the?sophage - Varix of the?sophage - Peptic ulcer - Abdominal pain - Cancer of the stomach - Functional dyspepsia

Diseases of - - gall bladder - biliary tree

- Cirrhosis - Stéatohépatite not-alcoholic - Primary biliary cirrhosis - Sclerosing primary Cholangite - Budd-Chiari Syndrome - Carcinome hépatocellulaire - Pancréatite (Acute Pancréatite and Chronic Pancréatite)- Cancer of the pancreas - - Cholécystite

Diseases of

congenital malformations - acquired anomalies - ignitions - tumours - Peptic ulcer - Intussusception - Malabsorption (for example c?liaque disease, Intolerance with lactose, Malabsorption of the fructose, Disease of Whipple) -

Diseases of

congenital malformations - acquired anomalies - ignitions - tumours - - Diverticulite - Diverticulose - Irritable colon (Disease of Crohn and ) - - Cancer colorectal - Disease of Hirschsprung - Pseudo-membranous colitis