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LIVER CIRRHOSIS CAUSES AND MANAGEMENT

Ramy A. Abdalla, Hashem Abdulwhab Jaml Allil , Jumanah Khalid Attiyah, Mansour A. Arishi , Asma Saleh Ahmad Alsaeed, Waleed Eid Alraddadi , Khlood Abdulali Alharbi, Elaf Mohammed Taha Ibraheem Fakeih, Ziyad Waleed Iskander , Fahad Saad Almathkar , Asma Saad Al Ahmari , Tahani Saleh A. Alsaery , Ahmed Abdullah Hakami

Introduction: Cirrhosis can be caused by many different mechanisms that involve hepatic injury and damage that could result in necroinflammation and fibrogenesis; histologically it is known by diffuse nodular regeneration surrounded by dense fibrotic septa with subsequent parenchymal extinction and collapse of liver structures, these can cause significant distortion of the liver vasculature architecture. This kind of distortion can result in higher resistance to portal blood flow which end up in portal hypertension and in hepatic synthetic dysfunction.Clinically, cirrhosis has been known as an end-stage disease that can lead to death, unless liver transplantation is conducted, and the only preventive methods have been screening for oesophageal varices and carcinoma.Recently, this has been studied, because 1-year mortality in cirrhosis differs very widely, from one percent to fifty percent depending on the clinical decompensations Histopathologists have suggested that the histological term cirrhosis must be substituted by advanced liver disease, to underline the dynamic processes and different prognosis of the disorder. Furthermore, fibrosis, even in the cirrhotic range, regresses with specific therapy, such as antiviral treatment for chronic hepatitis B or C. Aim of work: In this review, we will discuss liver cirrhosis.Methodology: We did a systematic search for liver cirrhosis using PubMed search engine (http://www.ncbi.nlm.nih.gov/) and Google Scholar search engine (https://scholar.google.com). All relevant studies were retrieved and discussed. We only included full articles.Conclusions: Cirrhosis is considered a worldwide trending cause of morbidity and mortality particularly in developed nations, it is thought to be one of the most common cause of death worldwide but about 4th in central Europe. Cirrhosis has been found to be not a single disease, but one that can be further divided into distinct clinical prognostic stages, with 1 year mortality ranging from one percent to fifty percent depending on the stage. In this review article we discussed the most recent understanding of cirrhosis as a dynamic process and outline current therapeutic options for prevention and management of complications of cirrhosis. The concept in management of patients with cirrhosis must be prevention and early intervention to stabilise disease progression and to avoid or delay clinical decompensation and the need for liver transplantation. Key words: liver cirrhosis, presentation, causes, epidemiology, management.

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