Patho Case Study 1

Cirrhosis is the eighth leading cause of death in the United States and the thirteenth leading cause of death worldwide.1 Cirrhosis is the irreversible fibrosis of the liver characterized by hepatic architectural distortion secondary to fibrous tissue and the formation of regenerative nodules.2 These anatomical changes cause hepatic vascular resistance and an increase in blood flow leading to portal hypertension. Porto-systemic collaterals develop in order to overcome the increased portal pressure gradient.3 Nitric oxide, an endogenous vasodilator is also released in effort to overcome portal pressure with the expense of causing systemic vasodilation and a decrease in blood pressure. As a result, a marked activation of neurohumoral vasoactive factors occurs in an effort to maintain an effective arterial blood pressure. Hypervolemia, increased cardiac index, decreased systemic vascular resistance, and systemic hypotension are manifestations of portal hypertension.3 Chronic hepatitis B virus (HBV), hepatitis C virus (HCV), alcoholism, nonalcoholic steatohepatitis (NASH), and non-alcoholic fatty liver disease (NAFLD) are all major causes of cirrhosis.

This case study is about Abdul Chidiac, a 51 year old male, married with 4 children. He had a medical history of hypertension, hypercholesterolaemia and cirrhosis with two admissions in the last six months. He is a smoker and drinks beer, 5-6 bottles per day. As Carithers & McClain (2010) explained the patient’s medical history is another indicator of the risk for cirrhosis; the progression to cirrhosis is adaptable and may take time over weeks or many years. Cirrhosis is a liver disease characterized by permanent scarring of the

In the presented case scenario, we have Mr. Gil Martin who is a 55-year-old Hispanic male. He comes in to the clinic today with complaints of weakness, fatigue, and loss of appetite. A student nurse will be precepting your assessment of Mr. Martin and when collecting subjective and objective data it is important to pay close detail to all findings. Ultimately this patient was diagnosis with cirrhosis, which is an abnormal liver condition that leads to irreversible scarring of the liver (National Institute of Health [NIH], 2017), so during assessment we should pay attention to details leading to this diagnosis.

Portal hypertension is a condition in which there is a dramatic increase of blood flow thru the hepatic portal vein. The portal vein is responsible for feeding blood to various parts of the gastrointestinal tract along with the spleen and liver. This condition develops due to an increase resistance of blood flow usually within the liver but can be also caused by pre and posthepatic conditions. However, the end result of this condition can lead to the development of variceal bleeding and ascites. Cirrhosis, scarring of the liver tissue, is the most common cause of portal hypertension due to damage liver cells and their inability to function properly, which causes a dramatic slow down of blood flow thru the organ. Unfortunately, portal hypertension

Symptomatic Criteria to HRS. I. Unending alternately intense liver infection for propelled hepatic disappointment Also portal hypertension.

Portal hypertension is an increase in blood pressure in a system of veins called the portal venous system or an increase in hepatic venous gradient. An increase in portal venous pressure above 10 mmHg or hepatic venous gradient more than 5 mmHg is diagnosed as portal hypertension (Hagen, 239). Hepatocellular disease is an example that causes portal hypertension. The disease causes a blockage of blood flow throughout the liver, which causes the blood to back up into the hepatic portal circulation. The backing up of blood causes the blood pressure in the hepatic circulation to increase, therefor it results in portal hypertension.

Cirrhosis is a condition of scarring of the liver which is caused when the liver has tried repairing itself following damage. This damage may come from a previous infection, such as from a form of hepatitis (usually hepatitis C) or damage done by the use of toxins, such as alcohol. Cirrhosis is irreversible but future damage can be slowed or prevented by treating the underlying cause.

Additionally, many chronic liver diseases can lead to cirrhosis. For example, nonalcoholic fatty liver disease (NAFLD) can lead to cirrhosis and is associated with obesity, hyperlipidemia, metabolic syndrome and type 2 diabetes mellitus. Hereditary metabolic disorders such as hemochromatosis and Wilson disease can also lead to cirrhosis (McCance & Heuther, 2014). It seems the cause of cirrhosis is multifaceted. Additionally, many diseases can lead to cirrhosis and it is understandable why the etiology of cirrhosis has not been parsed out, especially because the cause can differ from a

Portal hypertension is abnormal high blood pressure in the hepatic portal system. The Hepatic venous system is a significant role of supplying blood to the liver. The portal vein carries blood from the intestine, stomach, spleen, pancreas, and gallbladder and coursing through the liver. If the vessels in the liver are blocked due to hepatocellular diseases, blood cannot flow throughout the liver properly. As a result, the blood in the portal vein slows down and increases hepatic resistance. High resistance causes pressure increased, resulting in varices or dilation of the vessels.Normally, the portal venous pressure should not above 10 mmHg or the hepatic venous gradient is not more than 5 mmHg. If one of them is detected, that is a positive

One of these symptoms is jaundice, which is characterized by yellowish skin and eyes because of an inability of the liver to remove bilirubin from the blood. Patient with cirrhosis also suffering from itching, due to deposited bile's products in the skin. This patient also suffers from accumulation of fluid in legs that is called edema. As a result of the blockage of blood flow via the liver, fluid accumulation in abdomen which is worsen by the decrease in protein production. Other symptoms include fatigue, weakness, loss of appetite, weight loss and nausea. As the disease progress, complications may develop ,such as varices that happens with cirrhosis patient when the blood flow through the liver slows, so the blood from intestine go back to the vessels of the stomach and esophagus, these vessels are not meant to carry this much of blood so they dilate (varices), with increasing

Liver cirrhosis is a problem that can be caused by many liver diseases. It is a progressive disease itself, developing slowly over many years. It is characterized as scarring to the normal liver tissue which keeps this organ from working as it should and causes it to take on an abnormal structure. The diseases that lead to cirrhosis injure and kill liver cells. Scar tissue that has formed due to inflammation and repair, prevents the cells that have not died to properly replace the dead cells which result in newly formed cell clusters forming within the scar tissue.

Cirrhosis is a chronic and irreversible disease that causes cell destruction and fibrosis of the hepatic tissues. This scared tissue formation alters normal liver structure and vasculature that impairs blood and lymph flow. Ultimately resulting in hepatic insufficiency and hypertension in the portal vein. Three major forms of cirrhosis of the liver are Laennec’s cirrhosis, post necrotic cirrhosis, and biliary cirrhosis. Laennec’s cirrhosis results from malnutrition and chronic alcohol consumption. It is also the most common form of cirrhosis. Post necrotic cirrhosis results from drug induced massive hepatic necrosis and biliary cirrhosis consists of chronic bile obstruction. Cirrhosis is more prevalent among malnourished older adult men over

The pathophysiology of alcoholism begins after alcohol the ingestion of alcohol. It is absorbed and unaltered through the stomach and intestines. Next it is distributed throughout the body through the blood and absorbed by all tissues and fluids (Huether, 2012, p. 72). Furthermore, in the liver the alcohol blood content is metabolized into acetaldehyde by the enzymes process of alcohol dehydrogenase (ADH), the microsomal ethanol oxidizing system (MEOS), and catalase (Huether & McCance, 2012). Next, the metabolizing effects the central nervous system (CNS) and exhibits a depressant action. It is first expressed in the subcortical structures of the brain. This has an effect of disorientation of motor skills and intellect. With an increase in blood alcohol concentration, the medullary centers become depressed and as a result affects respiration (Huether & McCance, 2012). In addition, the effects of alcoholism encourage hepatic and gastric changes. The hepatic effect is caused by acetaldehyde, in which, induces inflammation, fatty deposits and enlargement of the liver (Huether & McCance, 2012).

Liver failure is the acute failure of the liver to perform its body function. Proteins that allow the blood to clot are not produced so the patient bruises and bleeds easily. A viscous fluid will sometimes collect

Alcohol has no beneficial attributes on a person’s health. Alcohol can have several harmful effects on human organs. Some organs in the human body that are damaged by alcohol consumption are the brain, kidneys, and liver. The human liver is the one organ that suffers the most damage. As stated in an article published by the National Institute on Alcohol Abuse and Alcoholism, “Because the liver is the chief organ responsible for metabolizing alcohol, it is especially vulnerable to alcohol – related injury” (NIAAA, 2005). Regular use of alcohol can lead to alcoholic liver disease (ALD). The severity of ALD can vary based on several different factors. Some of these factors include gender, age, the amount consumed, and how often alcohol is used. “ALD includes three conditions: fatty liver, alcoholic hepatitis and cirrhosis” (Alcohol Alert, 2005).