Pathophysiology of Liver Cirrhosis

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Chronic Alcoholism
(started drinking half gallon of tuba every day at the age of 16, beer and redhorse 2-3 times a week) Chronic Alcoholism
(started drinking half gallon of tuba every day at the age of 16, beer and redhorse 2-3 times a week) Liver Cirrhosis
Liver Cirrhosis
Risk Factors
* Chronic alcoholism
* Smoking
* Diet Malnutrition
Risk Factors
* Chronic alcoholism
* Smoking
* Diet Malnutrition
Predisposing Factors
* Age > 45 y/o
* Gender (more common in male)
* Asian
Predisposing Factors
* Age > 45 y/o
* Gender (more common in male)
* Asian

Chronic inflammation due to Helicobacter pylori
Chronic inflammation due to Helicobacter pylori

Adaptive increase in enzymes
Adaptive increase in enzymes

Liver cells became inflamed
Liver cells became inflamed
Inflammation of the lining of the stomach
(gastritis)
Inflammation of the lining of the stomach
(gastritis)
Contributing factors for hiatal hernia
* Farmer (heavy lifting or bending)
* smoking
Contributing factors for hiatal hernia
* Farmer (heavy lifting or bending)
* smoking

Ampicillin
Causes chronic active gastritis
Defect in gastrin regulation
Increased acid
H. pylori responses to increased gastrin
Contributes to erosion of mucosa
Ulcer formation
Gastric ulcer
Gastrointestinal bleeding
Causes chronic active gastritis
Defect in gastrin regulation
Increased acid
H. pylori responses to increased gastrin
Contributes to erosion of mucosa
Ulcer formation
Gastric ulcer
Gastrointestinal bleeding

Increased production of lipoproteins
Increased production of lipoproteins

Increased pressure on the abdomen
Increased pressure on the abdomen

Necrosis of hepatocyte
Necrosis of hepatocyte

Nausea, vomiting,
Pernicious anemia
Nausea, vomiting,
Pernicious anemia
Hyperlipidemia
Hyperlipidemia

Protrusion of the upper part of the stomach
Protrusion of the upper part of the stomach

Aorta is atherosclerotic
Aorta is atherosclerotic

Hiatal hernia
(2012)
Hiatal hernia
(2012)

Liver fibrosis and scarring
Liver fibrosis and scarring

Bleeding
Bleeding

Hematemesis
Hematemesis
Melena
Melena
Abdominal pain
Pain scale of 8/10
Abdominal pain
Pain scale of 8/10

Portal Obstruction
Portal Obstruction
Dangerous hemorrhage
Dangerous hemorrhage
Vessel may rupture
Vessel may rupture
Esophageal varices
Esophageal varices
Varicose will form
Varicose will form
Veins will be distended
Veins will be distended
Venus collateral shunt
(esophagus)
Venus collateral shunt
(esophagus)
Portal hypertension
Portal hypertension
Bile goes to the bloodstream
Bile goes to the bloodstream
Bile backflow from GI to the liver
Bile backflow from GI to the liver
Causing yellowing of the skin and the eye
(present)
Causing yellowing of the skin and the eye
(present)
Development of pressure gradient (12mmhg)
Development of pressure gradient (12mmhg)
Liver fibrosis and scarring
Liver fibrosis and scarring

Infiltration of fibroblast

Infiltration of fibroblast

Decrease liver function
Decrease liver function

Deficiency inVitamin A,D,E,K
Deficiency inVitamin A,D,E,K
Decrease absorption of fat-soluble vitamins
Decrease absorption of fat-soluble vitamins
Malabsorption of fats
Malabsorption of fats
Body malaise
(jan. 21 2013)
Body malaise
(jan. 21 2013)
Decrease glucose
Decrease glucose
Decrease energy
Decrease energy
Decreased metabolism of carbohydrates
Decreased metabolism of carbohydrates
Jaundice & Tea colored urine
Jaundice & Tea colored urine
Hyperbilirubinemia
Hyperbilirubinemia
Increased Urobilinogen
( High 418.1 umol/l)

Increased Urobilinogen
( High 418.1 umol/l)

Build up of conjugulated bilirubin in the blood
Build up of conjugulated bilirubin in the blood
Decreased Bilirubin metabolization and excretion
Decreased Bilirubin metabolization and excretion...
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