Portal Cirrhosis: Causes, Symptoms, and Clinical Management

Portal Cirrhosis: Causes, Symptoms, and Clinical Management

Question. Describe causes, clinical features and management of portal cirrhosis.

Answer. It is characterized by the diffse involvement of the liver in form of necrosis of liver cells, collapse of hepatic lobules, reticulin framework followed by diffse firosis and formation of structurally abnormal nodules.

• This interferes not only with liver blood flw, but also its function.
• This results in portal cirrhosis which is due to inadequacy of liver cells and portal hypertension.

“Understanding portal cirrhosis through FAQs: Causes, symptoms, and clinical management explained”

Causes Portal Cirrhosis.

• Hepatitis B and D
• Consumption of excessive alcohol
• Hemochromatosis
• Alpha-1 antitrypsin defiiency
• Autoimmune chronic active hepatitis
• Wilson’s disease
• Malaria
• Schistosomiasis
• Veno­occlusive disease
• Hepatic venous congestion to drugs like methyldopa etc.

“Importance of studying portal cirrhosis for healthcare professionals: Questions explained”

Clinical Features Portal Cirrhosis. Case of cirrhosis may present either in compensated or decompensated forms.

Compensated Form Portal Cirrhosis

• A compensated case of cirrhosis has features of dyspepsia in the form of morning anorexia, nausea, vomiting and vague ill­health.
  This is more so when it is early stage of alcoholic cirrhosis.
• There is palmar erythema, spider naevi, splenomegaly and hepatomegaly with a non tender liver.
• There is loss of weight, ill­health and edema of the ankles.
• There may be no fim signs of cirrhosis and diagnosis is made on clinical suspicion to be confimed by biochemical investigations and liver biopsy.
• This stage of compensated form of cirrhosis may continue for a variable period of time ranging from months to years and bleed from esophageal varices may draw attntion to the disease or some precipitating cause like severe bacteremia may produce hepatocellular decompensation.

“Common challenges in diagnosing and managing portal cirrhosis effectively: FAQs provided”

Decompensated Form Portal Cirrhosis

• A decompensated cirrhosis is characterized by a downhill course, abdominal distension, ascites, weight loss, edema over the dependent parts, cirrhotic facies (sunken eyes, hollow cheeks, pinched nose), skin dry and sallow.
• Jaundice may appear indicating progressive liver cell destruction.
• Liver may be palpable with irregular surface or it may not be palpable when it is shrunken.
• Splenomegaly is present in 80% of patients. Nails are white and clubbed.
• Endocrinal changes in the form of spider naevi, palmar erythema, gynecomastia, loss of axillary and pubic hair, and testicular atrophy are seen.
  There may be bleeding spots or bruising due to prothrombin defiiency.
• Ascites may be massive and is disproportionate to the edema of feet.
• Hepatocellular failure may supervene as liver cell necrosis proceeds.
• Breath becomes foul smelling often giving a mousy smell (Fetor hepaticus).
• Flapping tremors and encephalopathy appear.
• Appearance of jaundice, rapid accumulation of ascites and development of hepatic encephalopathy are poor signs in cirrhosis.

“Factors influencing success with portal cirrhosis knowledge: Q&A”

Management Portal Cirrhosis. It is palliative:

• Rest in bed: To maximize treatment of any reversible element of underlying liver disease and to improve renal perfusion.
• Correction ofany etiological factor: i.e. stoppage of alcohol, stoppage of drugs causing portal cirrhosis.
• Diet: Low salt. Total daily intake of 2000 calories with protein intake of 120 gm. If patient can tolerate it.
  Fats and carbohydrates in normal amount. Vitamin B complex.
• Symptomatic treatment:
  • For anemia vitamin B12 and folic acid is given
  • For restlessness sedatives such as lorazepam should be given
  • For ascites low sodium diet and diuretics should be given.