Physical Findings

Stop & Think

Lab and X-Ray

Differential Diagnosis

The Disease

Treatment

Conclusions

Quiz & Evaluation

The rearrangement of the hepatic vasculature in cirrhosis is one of the most important elements of this disease.

• New vascular channels in the developing fibrous tissue, connect with vascular elements in the portal regions. Blood is shunted away from the hepatic parenchyma.
• Fibrosis causes central vein compression and increased vascular resistance.
• Increased vascular resistance leads to hypertension in the portal vasculature.
• Consequences of portal hypertension:
• Ascites; the accumulation of excess peritoneal fluid.
• Portosystemic shunts; esophageal varices, hemorrhoids, caput medusae, spider angiomas.
• Congestive splenomegaly; leads to sequestration of WBCs, platelets and reduced RBC life span.
• Hepatic encephalopathy

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