15 Cirrhosis

Cause and Stellate

• find it on the sides of sinusoids in liver

• produce fibrous tissues in cirrhosis

General Symptoms

• liver convert ammonia to urea

• palmar erythema: thenar and hypothenar redness (think estrogen makes skin red)

Portal HTN

• hallmark in cirrhosis: vasodilation of splanchnic, low BP

• must have portal HTN to develop ascites

• portal HTN without cirrhosis

• blood clot in portal vein

Ascites

SAAG

Peritonitis

Diagnosis

• score includes bilirubin and INR (truly failing liver)

• no AST/ALT: liver damage but not irreversible

Treatment

• ammonia from amino acids and protein