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The symptoms are non-specific and vary widely, but it may present with the classical triad of: abdominal pain, ascites, and; liver enlargement. It is usually seen in younger adults, with the median age at diagnosis between 35 and 40 years, and it has a similar incidence in males and females. [2]
Other symptoms can develop based on the cause. For example, if portal vein thrombosis develops due to liver cirrhosis , bleeding or other signs of liver disease may be present. If portal vein thrombosis develops due to pylephlebitis , signs of infection such as fever, chills, or night sweats may be present.
The treatment of chronic liver disease depends on the cause. Specific conditions may be treated with medications including corticosteroids , interferon , antivirals , bile acids or other drugs. Supportive therapy for complications of cirrhosis include diuretics , albumin , vitamin K , blood products , antibiotics and nutritional therapy.
Cirrhosis has many possible causes, and more than one cause may be present. History taking is of importance in trying to determine the most likely cause. [2] Globally, 57% of cirrhosis is attributable to either hepatitis B (30%) or hepatitis C (27%). [47] [48] Alcohol use disorder is another major cause, accounting for about 20–40% of the cases.
Portal venous congestion causes venous blood leaving the stomach and intestines to be diverted along auxiliary routes of lesser resistance in order to drain to systemic circulation. With time, the small vessels that comprise a collateral path for porto-caval circulation become engorged and dilated.
Cirrhosis is the formation of fibrous tissue in the place of liver cells that have died due to a variety of causes, including viral hepatitis, alcohol overconsumption, and other forms of liver toxicity. Cirrhosis causes chronic liver failure. [15]
High intensity focused ultrasound (HIFU) (as opposed to diagnostic ultrasound) is an experimental technique which uses high-powered ultrasound waves to destroy tumor tissue. A systematic review assessed 12 articles involving a total of 318 patients with hepatocellular carcinoma treated with Yttrium -90 radioembolization. [ 84 ]
Pleural fluid causes symptoms far more easily than ascitic fluid, due to the lower volume of the pleural cavity as compared to the abdominal cavity. The main symptoms are usually related to the symptoms of liver cirrhosis and ascites. [4] Less often, it may be the only manifestation of chronic liver disease.
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