Here are the manifestations of chronic liver failure ,, Also known as Hepatocellular failure ( HCC) , which is caused by chronic degenerative liver diseases e.g Liver Cirrhosis .
1. General failure of health .
i.e Anorexia , loss of weight , easy fatigue , ......
2. Low grade Fever : due to failure of the lever to clear bacteria coming from the colon .
3. Fetor hepaticus : this is fecal smell of mouth due to lack of detoxification of Mercaptans absorbed from the colon ,, it occurs also with porto-systemic shunts .
4. Hepatocellular Jaundice : due to diminished uptake & excretion of bilirubin .
5. Ascites and Edema :
Edema of lower limbs usually follows acsites .
Ascites usually develops grudually ,, but it may develop Acutely in cases of haematemesis , melena , infection as SBP hypotension ( hypovolemia) , portal vein thrombosis and malignancy development .
6. Skin manifestations :
a- Palmar erythema : erythema opposite the heads of metacarpal bones , thenar & hypothenar eminences with central palmar pallor .
b. Spider naevi ,, each of them is a dilated arteriole with radiating capillaries ,, when compressing the central arteriole it causes blanching of capillaries .Spider naevi occur on the face , neck , upper limb & upper part of chest .
c. White nails .
7. Endocrinal changes : whose cause is not yet defined .
A . Male changes
Gynaecomastia , female distribution of suprapubic hair , decreased libido , impotence and testicular atrophy .
B. Female changes
Amenorrhoea , Sterility & decreased libido .
8. Cardio-Vascular manifestations :
a. Hyperkinetic circulation >> due to V.D materials esp. Nitric Oxide .
b. Cyanosis and Clubbing (Hepato-Pulmonary syndrome ) .
9. Hematological manifestations
Bleeding tendency , Anemia and Pancytopenia .
10. Hepatic Encephalopathy
it is a neuropsychiatric syndrome that may complicate severe liver disease and/or extensive portosystemic shunting .
11. Hepato-Renal syndrome :
it is Acute renal failure with normal renal histology occurs in Child C liver cirrhosis .
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