Pregledni rad

Liver Cirrhosis Complications and Their Treatment

Ivana Knežević Štromar
Matea Majerović

Sažetak

It is estimated that more than a million people worldwide die from liver cirrhosis every year. Alcohol consumption is still the most common cause of cirrhosis, but over the last two decades we have been witnessing a significant increase in the incidence of cirrhosis caused by non-alcoholic steatohepatitis. For a long time, cirrhosis was defined as a diffuse irreversible process causing architectural changes in the liver parenchyma. However, the progression of fibrosis largely depends on the underlying condition. There is even a possibility of regression, which depends on the options of treating the primary pathogenetic mechanism. Distinguishing between compensated and decompensated cirrhosis is not sufficient, as it does not allow proper stratification of risk for the development of complications, which require a subdivision of cirrhosis. It is also crucial to detect fibrosis at an early stage, preferably by non-invasive methods as well as serological markers. The transition from compensated to decompensated cirrhosis occurs at a rate of about 5% to 7% per year. Once decompensation occurs, cirrhosis becomes a systemic disease with multi-organ dysfunction. Decompensated cirrhosis has multiple complications, with ascites, spontaneous bacterial peritonitis, gastrointestinal bleeding, hepatorenal syndrome and encephalopathy being the most frequent. Patients with cirrhosis also present considerable changes in the coagulation cascade. Their natural anticoagulant mechanism is impaired and thromboembolic events are not rare. Therapy and prophylaxis of thromboembolic events in cirrhosis differ from those in patients without cirrhosis, and as such require a multidisciplinary approach. Malnutrition and sarcopenia are not characteristic only of decompensated cirrhosis and should be detected and treated in all stages of liver disease.

Ključne riječi

liver cirrhosis; liver fibrosis; decompensation; complications of liver cirrhosis; complications of decompensation; ascites, spontaneous bacterial peritonitis; gastrointestinal bleeding; hepatorenal syndrome

Hrčak ID:

232202

URI

https://hrcak.srce.hr/232202

Datum izdavanja:

15.1.2020.

Podaci na drugim jezicima: hrvatski

Posjeta: 11.184 *