Irreversible liver damage - loss of normal hepatic architecture
- Most commonly caused by alcohol abuse or HBV/HCV
- Leuconychia from the hypoalbuminaemia
- clubbing
- Palmar erythema
- Duputrens contracture
- Spider naevi
Cirrhosis may be present for years before becoming decompensated: Jaundice, Ascites or encephalopathy. Very bad prognostically but the following can be reversed to improve outcomes:
- Dehydration
- Constipation
- Covert alcohol use
- Infection (eg spontaneous peritonitis)
- Opiate over-use (constipation)
- Occult GI bleed
- (Portal vein thrombosis)