Cirrhosis: Difference between revisions

Line 1: Line 1:
===Background===
===Background===
A generally irreversible fibrotic scaring of the liver parenchyma.


===Differential===
===Differential===

Revision as of 17:40, 15 June 2016

Background

A generally irreversible fibrotic scaring of the liver parenchyma.

Differential

  • Hepatitis chronic B and C
  • Alcoholic liver disease
  • Non-alcoholic steatohepatitis
  • Drug induced (ie. Tylenol)
  • Cardiac Cirrhosis
  • Primary biliary cirrhosis
  • Primary sclerosing cholangitis
  • Autoimmune Hepatitis
  • Alpha1 anti-trypsin Deficiency
  • Cystic Fibrosis

Clinical Features

Child-Pugh Classification for Cirrhosis Mortality

+1 +2 +3
Bilirubin <2 mg/dL 2-3 mg/dL >3 Mg/dL
Albumin >3.5 mg/dL 2.8-3.5 mg/dL <2.8 mg/dL
INR <1.7 1.7-2.2 >2.2
Ascites No ascites Ascites, medically controlled Ascites, poorly controlled
Encephalopathy No encephalopathy Encephalopathy, medically controlled Encephalopathy, poorly controlled
  • Score ≤ 7 = Class A = 100% and 85% one and two-year patient survival
  • Score 7 - 9 = Class B = 80% and 60% one and two-year patient survival
  • Score ≥ 10 = Class c = 45% and 35% one and two-year patient survival


MELD-Na Score (Model End Stage Liver Disease)

MELD-Na Score 3-month mortality
40 71.3%
30-39 52.6%
20-29 19.6%
10-19 6.0%
<9 1.9%

Management

Disposition