Gabriel Damarwibawa Setianto, - and Ummi Maimunah, Ummi (2024) Unraveling Hepatic Cirrhosis through its Pathophysiology, Diagnosis, and Predictors of Mortality: A Literature Review. International Journal of Research Publications, 140 (1). pp. 394-403. ISSN '2708-3578

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Abstract

Abstract This literature review provides a comprehensive examination of hepatic cirrhosis, focusing on its pathophysiology, diagnosis, and predictors of mortality. Hepatic cirrhosis, characterized by fibrosis and nodular formations resulting from continuous scarring, irreversibly alters liver structure and function. The disease progression involves the activation of the extracellular matrix, particularly collagen accumulation, leading to hepatocellular dysfunction and portal hypertension. Epidemiologically, liver cirrhosis poses a significant global health burden, with a substantial increase in prevalence reported in recent years, particularly in the Asia Pacific region. The etiology of cirrhosis involves various factors, including viral infections (hepatitis B and C), alcohol abuse, autoimmune diseases, metabolic disorders, and more. Understanding the pathophysiology is crucial, with hepatic stellate cells, liver sinusoidal endothelial cells, Kupffer cells, and hepatocytes playing key roles in fibrogenesis. Clinical manifestations range from asymptomatic cases in compensated cirrhosis to severe complications in decompensated cirrhosis, such as ascites, jaundice, encephalopathy, variceal bleeding, and hepatocellular carcinoma. Accurate diagnosis is essential for effective management. Liver biopsy, serological tests, and various imaging modalities, including ultrasound, contrast-enhanced ultrasonography, magnetic resonance elastography, and CT scans, aid in distinguishing between compensated and decompensated cirrhosis. Complications, including portal hypertension, hepatic encephalopathy, esophageal varices, hepatocellular carcinoma, ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome, further contribute to the complexity of cirrhosis. The paper also explores predictor factors of mortality in cirrhosis patients, including age, comorbidities, Model for End-Stage Liver Disease with Sodium (MELD-Na) score, and Child-Turcotte-Pugh (CTP) score. Understanding these factors enhances prognostic accuracy, facilitating improved patient care and timely interventions. Overall, this review aims to provide a comprehensive understanding of hepatic cirrhosis, aiding healthcare professionals in its diagnosis, management, and risk stratification.

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