Cirrhosis is a topic covered in the Washington Manual of Medical Therapeutics.

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  • Cirrhosis is a chronic condition characterized by diffuse replacement of liver cells by fibrotic tissue, which creates a nodular-appearing distortion of the normal liver architecture. Advanced fibrosis represents the end result of many etiologies of liver injury.
  • Cirrhosis affects nearly 5.5 million Americans. In 2009, it was the 12th leading cause of death in the United States.1
  • The most common etiologies are alcohol-related liver disease, chronic viral infection, and NAFLD (diagnosis and treatment discussed earlier in respective sections).
  • Main complications of cirrhosis include portal hypertension with various clinical manifestations (ascites, esophageal and gastric varices, portal hypertensive gastropathy and colopathy, hypersplenism, gastric antral vascular ectasia, spontaneous bacterial peritonitis [SBP], hepatorenal syndrome [HRS], hepatic encephalopathy, and HCC). Frequent laboratory abnormalities encountered in a patient with cirrhosis include anemia, leukopenia, thrombocytopenia, hypoalbuminemia, coagulopathy, and hyperbilirubinemia.

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