Cirrhosis

Hepatic cirrhosis is the endpoint of different toxic, autoimmune, congenital or infectious diseases (see Table 4).

Different pathologies leading to hepatic cirrhosis

Toxic

  • Alcohol Methotrexate Isoniazid :                           Methyldopa Amiodarone
  • Infections Hepatitis B and C :                                Schistosomiasis
  • Autoimmune Chronic active hepatitis                  Primary biliary cirrhosis

Metabolic

  • Wilson’s disease
  • α-1-antitrypsin-deficiency                            Hemochromatosis
  • Glycogen storage disease                             Galactosemia
  • Diseases of urea cycle                                 Tyrosinemia
  •                                                                       Abetalipoproteinemia  

Biliary obstruction

  • Atresia                                              Strictures, Cystic fibrosis
  • Cholelithiasis
  • Sclerosing cholangitis

Vascular

  • Budd-Chiari syndrome                   Veno-occlusive disease
  • Chronic cardiac insufficiency        Hereditary hemorrhagic teleangiectasia   with AV-shunts

Others

  • Neonatal hepatitis-syndrome                Indian childhood cirrhosis
  • Intestinal bypass                                 Sarcoidosis

Fibrosis is an integral part of cirrhosis and differentiates it from nodular regenerative hyperplasia. Structurally abnormal nodules may often occur
but sometimes they can only be identified by means of subtle architectural changes, such as a disordered or compressed cell plate pattern. Although
abnormalities in vasculature and blood flow are very important, they are not included in the definition since these changes are a consequence of the other pathologic features rather than primary abnormalities. Equally, true regenerative nodules can be a late occurrence in cirrhosis and therefore regeneration is also excluded from the definition. Although regeneration is not essential for the diagnosis of cirrhosis, it is important to point out that regeneration is a critical factor influencing the evolution of cirrhosis.

TUMOR OF THE LIVER (CIRRHOSIS)

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