Liver Decompensation

The liver is critical to survival. Infection, chemical toxicity, ischemia or inflammation can damage or kill liver cells, but the remaining cells can often compensate with increased metabolic function or regeneration. If liver injury or cell loss outstrips its ability to compensate, the liver functions of biotransformation, glycogenolysis, gluconeogenesis, protein synthesis, filtration, etc., will diminish.

As the liver fails, the body will exhibit signs of hepatic insufficiency. Minor signs including: nausea, diarrhea, anorexia and fatigue. More serious liver decompensation is associated systemic signs and symptoms.

Central Nervous Systems

  • Altered Mental Status
  • (Encephalopathy)
  • Asterixis
  • Cerebral edema

Hematological

  • Thrombocytopenia
  • Coagulopathy
  • Hyperbilirubinemia >2

Cardiovascular

  • Hypotension
  • Portal hypertension
    • Varices, Ascites, Edema

Metabolic

  • Hypoglycemia
  • Feotor hepaticus

Hepatorenal syndrome

  • Splanchic arterial vasodilatation
  • Na+ & H20 retention, ascites

Endocrine

  • Testicular atrophy
  • Gynecomastia
  • Menstrual irregularities

Respiratory

  • Hepatopulmonary Syndrome
  • Pleural effusion

Skin

  • Pruritus
  • Spider angiomas
  • Palmer erythema

GI

  • N/V
  • Malnutrition
  • Spontaneous bacterial peritonitis

Immunologic

  • Phagocytic dysfunction
  • Complement deficiency
  • Sepsis

Liver

  • Hypoproteinemia
  • Cholestasis
  • Jaundice
  • Pain

Musculoskeletal

  • Dupuytrens contracture
  • Osteoarthropathy
  • Muscle wasting

Reference

Stanford Medicine 25. (n.d.). Liver disease, head to Foot. Stanford Medicine 25. Retrieved November 14, 2021, from https://stanfordmedicine25.stanford.edu/the25/liverdisease.html.

 

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