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VIII.28 - Cirrhosis

from Part VIII - Major Human Diseases Past and Present

Published online by Cambridge University Press:  28 March 2008

Kenneth F. Kiple
Affiliation:
Bowling Green State University, Ohio
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Summary

Cirrhosis is a chronic hepatic disorder, anatomically characterized by diffuse liver fibrosis and nodule formation. These pathological changes produce the clinical features of portal hypertension and hepatocellular failure. Cirrhosis is the end product of progressive liver injury resulting from many diverse causes including toxins, drugs, viruses, and parasites. The clinical manifestations of cirrhosis vary according to the severity and duration of the underlying disease. In the West, cirrhosis is a major cause of disability and death among middle-aged alcoholic males. In the East and Africa, cirrhosis is predominantly an intermediate lesion in the evolution from chronic hepatitis B infection to primary hepatocellular carcinoma.

Classification

Cirrhosis is classified on the basis of morphology and etiology. The morphological classification recognizes three types based on the size of the nodules:

1. Macronodular cirrhosis. The liver is firm, large or small in size, with bulging irregular nodules greater than 3 millimeters in diameter.

2. Micronodular cirrhosis. The liver is usually enlarged, and very firm or hard in consistency. The nodules on cut sections appear small and uniform, less than 3 millimeters wide.

3. Mixed micro/macronodular cirrhosis. The liver shows groups of small nodules interspersed with fields of large nodules.

The terms “micronodular” and “macronodular” cirrhosis replace the older terminology, Laennec’s and postnecrotic cirrhosis.

Neither the gross nor the microscopic appearance of the liver can alone differentiate among the many causes (see Table VIII.28.1). In individual cases, the etiology is often unknown. Alcohol injury is most frequently associated with the pattern of micronodular cirrhosis, and other causes in this category include primary biliary cirrhosis, primary hemochromatosis, and chronic right heart failure.

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Publisher: Cambridge University Press
Print publication year: 1993

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References

Chen, Thomas S., and Chen, Peter S.. 1984. Understanding the liver: A history. Westport, Conn.Google Scholar
Conn, Harold O., and Attenbury, Colin E.. 1987. Cirrhosis. In Diseases of the liver, 6th edition, ed. Schiff, Leon and Schiff, Eugene R.. Philadelphia.Google Scholar
Galambos, John T.Cirrhosis. 1979. Philadelphia.Google ScholarPubMed
Garagliano, Cederic F., Lilienfeld, Abraham M., and Mendeldoff, Albert I.. 1979. Incidence rates of liver cirrhosis and related diseases in Baltimore and selected areas of the United States. Journal of Chronic Disease 32.CrossRefGoogle ScholarPubMed
Herd, Denise. 1985. Migration, cultural transformation and the rise of black liver cirrhosis mortality. British Journal of Addiction 80.Google ScholarPubMed
Jorke, D., and Reinhardt, M.. 1982. Contributions to the epidemiology of liver cirrhosis and chronic hepatitis. Deutsche Zeitschrift fiir Verdauungs-und Stoffwechselkrankheiten 42.Google ScholarPubMed
Millward-Sadler, G. H., Hahn, E. G., and Wright, Ralph. 1985. Cirrhosis: An appraisal. In Liver and biliary disease, 2d edition, ed. Wright, Ralph et al. Philadelphia.Google Scholar
Tuyns, A. J., and Pequignot, G.. 1984. Greater risk of ascitic cirrhosis in females in relation to alcohol consumption. Internationsl Journal of Epidemiology 13.Google ScholarPubMed

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  • Cirrhosis
  • Edited by Kenneth F. Kiple, Bowling Green State University, Ohio
  • Book: The Cambridge World History of Human Disease
  • Online publication: 28 March 2008
  • Chapter DOI: https://doi.org/10.1017/CHOL9780521332866.090
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  • Cirrhosis
  • Edited by Kenneth F. Kiple, Bowling Green State University, Ohio
  • Book: The Cambridge World History of Human Disease
  • Online publication: 28 March 2008
  • Chapter DOI: https://doi.org/10.1017/CHOL9780521332866.090
Available formats
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Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Cirrhosis
  • Edited by Kenneth F. Kiple, Bowling Green State University, Ohio
  • Book: The Cambridge World History of Human Disease
  • Online publication: 28 March 2008
  • Chapter DOI: https://doi.org/10.1017/CHOL9780521332866.090
Available formats
×