Cirrhosis is the last and irreversible stage of deterioration of the liver, represented by the destruction of the parenchyma (it is the functional component of the liver, composed of hepatocytes that filter the blood to eliminate toxins) and the formation of fibrotic regeneration nodules, mainly related to viral diseases such as Hepatitis B or C, or with chronic alcohol consumption.
This causes a physiopathological mechanism by increasing the pressure in the portal system.
Can You Die Suddenly From Cirrhosis Of The Liver?
Spontaneous hemoperitoneum secondary to rupture of intraabdominal varices is a serious and often deadly condition. The bleeding sites are diverse and have been described at the bottom of the sack of Douglas, in the subdiaphragmatic veins, in the retroperitoneum of the right colon, the root of the mesentery, the gastrohepatic ligament and perisplenic veins and the tail of the pancreas.
The initial clinical manifestations of hemoperitoneum include pain and distension with increased abdominal diameter, besides dizziness or syncope. Hypotension is almost universal.
Other complications of cirrhosis of the liver that may lead to death are:
Edema and Ascites: When the hepatic damage is in an advanced stage, liquid is accumulated in the legs (edema) and in the abdomen (ascites). Ascites can cause bacterial peritonitis, which is a serious infection.
Hemorrhages: When the production of proteins necessary for blood coagulation by the liver stops or slows down, the person suffers haemorrhages easily.
Portal Hypertension: Cirrhosis slows down the normal circulation of blood, which increases the pressure in the portal vein.
Esophageal Varices and Gastropathy: When portal hypertension occurs, it can cause enlarged blood vessels in the esophagus, called varices, or in the stomach, called gastropathy, or both. Enlarged blood vessels are more likely to burst due to thin walls and increased pressure. If they burst, urgent medical attention will be required.
Splenomegaly: When portal hypertension occurs, the spleen often enlarges and retains white blood cells and platelets, decreasing the number of these cells in the blood.
Jaundice: Jaundice occurs when the diseased liver does not remove enough bilirubin from the blood, which causes a yellowing of the skin and the sclera of the eyes, and darkening of the urine.
Gallstones: If cirrhosis does not allow the free flow of bile to and from the gallbladder, bile hardens and gallstones form.
Drug Sensitivity: Cirrhosis slows the liver’s ability to filter medications in the blood. When this happens, the drugs act for longer than normal and accumulate in the body. This causes a greater sensitivity of the person to the medicines and their side effects.
Hepatic Encephalopathy: If the liver fails, it cannot eliminate toxins from the blood and eventually they accumulate in the brain. The accumulation of toxins in the brain, called hepatic encephalopathy, can cause a decrease in mental functioning and coma. Signs of decreased mental functioning include confusion, personality changes, memory loss, concentration problems and change in sleep habits.
Insulin Resistance and Type 2 Diabetes: Cirrhosis causes resistance to insulin, a hormone produced by the pancreas that allows the body to use glucose as energy. With insulin resistance, the muscles and fats of the body as well as the liver cells do not use insulin properly. The pancreas tries to satisfy the demand for insulin by producing more, but excess glucose accumulates in the bloodstream and causes type 2 diabetes.
Liver Cancer: Hepatocellular carcinoma is a type of liver cancer that can occur in people with cirrhosis. Hepatocellular carcinoma has a high mortality rate, but there are several treatment options available.
Portal hypertension is responsible for the appearance of esophageal varices, it also generates intraabdominal varicosities dilatations, especially in the perisplenic and mesenteric veins, as well as esophageal, and they are susceptible to breaking and bleeding within the peritoneal cavity.
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