Basic information about liver cirrhosis

Cirrhosis is terminal and irreversible stage of chronic liver disease and is characterized by diffuse destruction and simultaneous regeneration of liver cells, leading to excessive production of connective tissue disorders and major structures of the liver. Cirrhosis of the liver, the histopathological findings of the dominant fibrotic changes with the creation of renewed nodes, caused by a number of necrotic hepatocytes, supporting the collapse of the reticular network and liver vakularizacije. Fibrosis leads to the formation of fibrous septa that spread through the liver parenchyma is associated with central vein with portal fields. Also visible are a number of vascular anastomoses.

Whatever the cause, histopathologic findings in the liver parenchyma may be identical or minimal differences, and the classification of cirrhosis by histopathologic analysis because a lot more difficult.

For now, the accepted division into three basic forms:

Morphological,

and pathophysiological

etiology.

1) Based on morphological characteristics, liver is divided into:

Mikronodular (visible in the liver parenhemu numerous nodules smaller than 1 cm in diameter)

Makronodular(number of visible nodules sized 3-5 cm in diameter)

Mixed (nodules represented range from 1 to 5 cm in diameter).

2) According to the histopathological findings, liver is divided into:

the portal,

postnecrotic,

posthepatic,

and biliary

Cardiac cirrhosis.

The portal in the etiology of cirrhosis often is alcohol. It is characterized by enlarged liver (up to 4000 grams), as a result of fatty liver infiltration and proliferation of smooth endoplasmic reticulum.

Postnecrotic liver is rich in numerous areas of necrosis of hepatocytes. With the loss of stromal fibrosis, and that is in the form of broad band spreading through the hepatic parenchyma, forming nodules of different sizes (a few millimeters to 5 cm). This is usually a result of viral hepatitis B or C, although other etiologic agents should be mentioned more hepatotoxic drugs and metabolic diseases.

Posthepatic cirrhosis of the liver is described as a special form, as a transitional form between cirrhosis and portal postnekrotičke.

As a result of long-term intrahepatic and extrahepatic biliary tract obstruction occurs and is mentioned as a special form of biliary cirrhosis. The obstruction leads to swelling of difficult bile, causing mechanical jaundice, which results in destruction of hepatocytes and subsequent cirrhosis progressively. Grossly speaking, the liver is enlarged, firm, dark green, wide scar divided into larger and smaller pieces.

Cardiac cirrhosis is a form of cirrhosis of the liver that occurs as a result of long-term right heart decompensation.Reduced stroke volume of the heart causes extended congestion and ischemia of the liver parenchyma with subsequent necrosis of liver cells, mainly around the central vein and accompanying fibrosis. On the surface of the liver are seen sporadically or hipermična pale of the liver gives the typical appearance of nutmeg.

3) the etiology of cirrhosis of the liver:

Virisni hepatitis B and C

Alcohol

Other infectious diseases (toksmoplazmoza, brucellosis)

Medications that cause liver damage

Immune disorders (autoimmune hepatitis)

Long-term cholestasis

Metabolic causes (Wilson's disease, hemochromatosis, cystic fibrosis, ...)

Sarcoidosis

Cryptogenic cirrhosis or cirrhosis of unknown cause.

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