Overview of Cirrhosis

Cirrhosis, a final pathway for a wide variety of chronic liver diseases ( Box 74.1 ), is a pathologic entity defined as diffuse hepatic fibrosis with the replacement of the normal liver architecture by nodules. The rate of progression of chronic liver disease to cirrhosis may be quite variable, from weeks in patients with complete biliary obstruction to decades in patients with chronic hepatitis C. Cirrhosis is one of the leading causes of mortality in the USA and particularly afflicts persons in the most productive years of their lives. Acute-on-chronic liver failure (ACLF) is also discussed in this chapter, and the protean complications of cirrhosis ( Box 74.2 ) are discussed in other chapters (see Chapter 21, Chapter 92, Chapter 93, Chapter 94 and 96 ).