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Natural History and Stages of Cirrhosis

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Variceal Hemorrhage

Abstract

Cirrhosis of the liver develops usually slowly during inflammatory diseases which cause progressive accumulation of fibrosis and distortion of the liver structure. There are two major clinical phases of the disease, recognized as clinically distinct entities: compensated and decompensated cirrhosis. Compensated cirrhosis is characterized by a very low mortality, while transition to decompensation is the major outcome for this early disease stage. Following decompensation median survival is approximately 2–4 years. Esophageal varices, ascites, bleeding, jaundice, and encephalopathy allow identification of disease stages with significantly different outcomes. In most patients, sepsis, renal failure, and acute-on-chronic liver failure occur as end stage events anticipating death. Hepatocellular carcinoma may occur along the whole course of cirrhosis and, whenever it occurs, significantly worsens the outcome. The Child-Pugh score or its components, age, portal hypertension, renal function, and the model for end stage liver disease, are among the most widely recognized prognostic indicators of mortality.

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Authors and Affiliations

  1. Department of Gastroenterology, Hospital V. Cervello, Via Trabucco 180, Palermo, 90146, Italy

    Gennaro D’Amico M.D.

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  1. Gennaro D’Amico M.D.
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Correspondence to Gennaro D’Amico M.D. .

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  1. Luigi Sacco University Hospital, University of Milan, Milan, Italy

    Roberto de Franchis

  2. Ospedale Universitario Luigi Sacco, Universitá degli Studi di Milano, UOC Gastroenterologia, Milano, Italy

    Alessandra Dell’Era

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D’Amico, G. (2014). Natural History and Stages of Cirrhosis. In: de Franchis, R., Dell’Era, A. (eds) Variceal Hemorrhage. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0002-2_2

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  • DOI: https://doi.org/10.1007/978-1-4939-0002-2_2

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