The Complications of Cirrhosis of the Liver

Abstract

Bleeding esophageal varices, ascites, hepatic coma, and peptic ulcer, 4 serious liver cirrhosis complications were discussed diagnostically and therapeutically. A thorough history and physical examination plus liver function tests and Ba X-ray series proved most valuable in the emergency diagnosis of bleeding esophageal varices. Supplementary and more complicated diagnostic procedures are of value but are required infrequently. The emergency treatment of varix hemorrhage consists of certain general measures and prompt restoration of blood volume. Two specific emergency surgical treatments used are transesophageal varix ligation and emergency porta caval shunt the latter resulting in the greatest long-term survival rate. Ascites may be due to several factors but primarily to postsinusoidal obstruction and intrahepatic hypertension. The majority of the patients respond to a medical regimen, those who do not may be managed by a side-to-side portacaval shunt. Hepatic coma appears to be due to accumulation of toxic introgenous substances and treatment is directed to overcoming hepatic failure by diet and antibiotics. Peptic ulcer maybe due to hypersecretion of gastric acid following portacaval shunt due to hepatic aypon of a humoral agent arising in the intestines and the secretogogue may be histamine.