Cirrhosis Essay

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DEFINITION (1)

Cirrhosis can be simply defined as diffuse fibrosis associated with parenchymal nodules.
It involves the whole liver rather than a small part even though on occasion the fibrosis may be more severe in one or other lobe. Fibrosis results partially from collapse of the new fibre formation and is usually regarded as a consequence of liver-cell necrosis. The nodules of a cirrhotic liver are the surviving parenchyma. But they are strutually altered. They vary greatly in size and appearance. Within them, there may be little organized structure which is similar to normal lobule and acini. In biliary cirrhosis and haemochromatosis, the parenchyma remains normal for a long period and fibrosis is the dominant pathological process. But true cirrhosis occurs only when lobular architecture becomes altered.

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LIVER CELL CHANGES (1)
The common change is liver cell necrosis. It may be the form of an acute hepatitis or viral or alcoholic type. Alternatively there may be continuous liver cell damage as in metabolic disorders. When necrosis is massive as in severe viral or drug induced hepatitis, the areas of surviving parenchyma are assumed to undergo regeneration but fail to reproduce normal lobular or acinar architecture. The compressed necrotic zones then form the basis of the fibrous septa of the cirrhotic liver.
In biliary cirrhosis and haemochromatosis, the eventual transition to cirrhosis is presumably de...

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... Clotting process propagation by the coagulation cascade
• Clotting termination by antithrombic mechanisms
• Clot removal by fibrinolysis

The liver plays central role in each of these phases of clotting process, as it synthesizes the majority of coagulation factors and proteins involved in fibrinolysis as well as thrombopoietin., which is responsible for platelet production from megakaryocytes. In cirrhosis, liver is badly get damaged. So the production of coagulation factors and proteins is impaired. Many pathological processes associated with cirrhosis, such as portal hypertension and endothelial dysfunction as well as co-morbid conditions, may also alter the coagulation process. Consequently, patients with liver disease as in cirrhosis, have a disturbed balance of procoagulant and anti- coagulant factors which deviates from the normal coagulation cascade.

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