Recent Advances in Liver Cirrhosis Related Complications.

Format:

Book

Author/Creator:

Qi, Xingshun.

Contributor:

You, Hong.

Language:

English

Physical Description:

1 online resource (725 pages)

Edition:

1st ed.

Place of Publication:

Chantilly : Elsevier Science & Technology, 2025.

Summary:

Recent Advances in Liver Cirrhosis Related Complications provides comprehensive coverage of the contemporary management of liver cirrhosis related complications and provide future directions for the field.Content covers epidemiology, diagnosis and risk stratification, and pathophysiology of liver cirrhosis.

Contents:

Front Cover

Recent Advances in Liver Cirrhosis-Related Complications

Copyright Page

Contents

List of contributors

Preface

Acknowledgment

1 Epidemiological insights into liver cirrhosis

1.1 Introduction

1.2 Prevalence, incidence, and mortality

1.3 Etiology

1.4 Risk factors

1.4.1 Alcohol consumption

1.4.2 Viral hepatitis

1.4.3 Metabolic dysfunction-associated fatty liver disease

1.4.4 Genetics

1.5 Demographics and vulnerable populations

1.6 Prevention and intervention

1.7 Conclusion

References

2 Diagnosis and risk stratification of liver cirrhosis

2.1 Introduction

2.2 Clinical presentation

2.3 Diagnosis

2.3.1 Biopsy

2.3.2 Noninvasive methods

2.3.2.1 Imaging

2.3.2.1.1 Ultrasound

2.3.2.1.2 Doppler/contrast-enhanced ultrasound

2.3.2.1.3 Computed tomography/magnetic resoannce imaging

2.3.2.2 US-based elastography

2.3.2.2.1 Principle

2.3.2.2.2 Methodology

2.3.2.2.2.1 Strain elastography

2.3.2.2.2.2 Shear wave elastography

2.3.2.3 Magnetic resonance-based elastography

2.3.2.4 Serum marker

2.4 Risk stratification/staging

2.5 Conclusion

3 Pathophysiology of portal hypertension in liver cirrhosis

3.1 Clinical relevance of portal hypertension in cirrhosis

3.2 Pathophysiology of portal hypertension in cirrhosis-intra-hepatic events

3.2.1 Intrahepatic resistance-structural component

3.2.2 Intrahepatic resistance-dynamic component

3.3 Pathophysiology of portal hypertension in cirrhosis-splanchnic and systemic hemodynamics

3.3.1 Hemodynamic component-splanchnic circulation

3.3.2 Hemodynamic component-systemic cardiovascular abnormalities

4 Gut microbiota in liver cirrhosis

4.1 Introduction

4.2 Intestinal dysfunction and fundamental microbial changes in cirrhosis.

4.3 Changes to the gut microbiota, etiologies, and clinical outcomes in cirrhosis

4.3.1 Alcohol-related liver disease

4.3.2 Metabolic-dysfunction-associated steatotic liver disease

4.3.3 Chronic viral hepatitis

4.4 Gut dysbiosis and complications of cirrhosis

4.5 Nonbacteria-related gut microbial dysbiosis in cirrhosis

4.6 Modulating the gut microbiota in cirrhosis

4.7 Summary and conclusions

5 Ascites in liver cirrhosis

5.1 Introduction

5.2 Pathogenesis

5.3 Diagnosis and evaluation of ascites

5.4 Treatment of ascites

5.4.1 Uncomplicated ascites

5.4.1.1 General treatment

5.4.1.2 Diuretics

5.4.2 Refractory ascites

5.4.2.1 Large-volume paracentesis

5.4.2.2 Transjugular intrahepatic portosystemic shunt

5.4.2.3 Liver transplantation

5.4.2.4 Novel treatments

5.4.2.5 Palliative treatments

5.5 Conclusion

6 Gastrointestinal bleeding in liver cirrhosis

6.1 Introduction

6.2 Pathophysiology of gastrointestinal bleeding in liver cirrhosis

6.2.1 Overview of portal hypertension and its role in bleeding

6.2.2 Variceal bleeding

6.2.3 Other causes of bleeding in liver cirrhosis

6.3 Diagnosis of gastrointestinal bleeding

6.4 Management of acute gastrointestinal bleeding

6.4.1 Hemodynamic resuscitation

6.4.2 Risk stratification

6.4.3 Pharmacological interventions

6.4.3.1 Use of vasoactive drugs

6.4.3.2 Role of antibiotics prophylaxis

6.4.4 Timing of endoscopy

6.4.5 Endoscopic therapy for variceal bleeding

6.4.5.1 Esophageal varices

6.4.5.2 Gastric varices

6.4.6 Trans-jugular intrahepatic portosystemic shunt

6.4.7 Balloon-occluded retrograde transvenous obliteration

6.4.8 Surgical interventions

6.5 Prevention of gastrointestinal bleeding

6.5.1 Primary prevention

6.5.2 Secondary prevention

6.6 Conclusion.

References

7 Hepatic encephalopathy

7.1 Definition and epidemiology

7.2 Classification

7.3 Pathogenesis

7.4 Precipitant factors

7.4.1 "Classic precipitants"

7.4.1.1 Infections

7.4.1.2 Gastrointestinal bleeding

7.4.1.3 Dehydratation and electrolyte imbalances

7.4.1.4 Drugs

7.4.1.5 Constipation

7.4.2 "New precipitants"

7.4.2.1 "Gut-liver-brain axis"

7.4.2.2 Malnutrition and muscle changes

7.4.2.3 Hypoalbuminemia

7.4.2.4 Spontaneous portosystemic shunts

7.4.2.5 Transjugular intrahepatic portosystemic shunt

7.5 Clinical manifestation

7.6 Diagnosis of overt hepatic encephalopathy

7.7 Diagnosis of minimal hepatic encephalopathy

7.8 Therapy

7.9 Conclusion

8 Acute kidney injury in liver cirrhosis

8.1 Introduction

8.2 Classification of renal dysfunction in cirrhosis

8.3 Pathophysiology of hepatorenal syndrome-acute kidney injury

8.3.1 Hemodynamic abnormalities

8.3.2 The role of inflammation

8.4 Diagnosis and differential diagnosis of hepatorenal syndrome-acute kidney injury

8.4.1 The role of biomarkers

8.5 Management of hepatorenal syndrome-acute kidney injury

8.5.1 General measures

8.5.2 Albumin

8.5.3 Vasoconstrictors

8.5.3.1 Terlipressin

8.5.3.2 Norepinephrine

8.5.3.3 Midodrine and octreotide combination

8.5.4 Renal replacement therapy

8.5.5 Liver transplantation

8.5.6 Simultaneous liver kidney transplant

8.6 Prognosis

9 Bacterial infections in liver cirrhosis

9.1 Bacterial infections in liver cirrhosis

9.2 Bacterial infections in patients with decompensated cirrhosis

9.3 Clinical features, diagnostic workup, and therapeutic management of bacterial infection in patients with decompensated.

9.4 Possible role of biomarkers of bacterial infection to strengthen or rule out the suspicion of bacterial infection

9.5 Initial management of suspected bacterial infection at hospital admission

9.6 Bacterial infections in clinical settings unique to decompensated cirrhosis

9.6.1 Acute variceal bleeding

9.6.1.1 Guidelines suggested antibiotic prophylaxis in patients with acute variceal bleeding

9.6.2 Spontaneous bacterial peritonitis

9.6.2.1 Guidelines suggested antibiotic treatment in patients with spontaneous bacterial peritonitis

9.6.2.2 Failure of first-line treatment

9.6.2.3 Albumin infusion in patients with spontaneous bacterial peritonitis

9.6.2.4 Bacterascites

9.6.2.5 Spontaneous bacterial empyema

9.6.2.6 Primary prophylaxis of spontaneous bacterial peritonitis

9.6.2.7 Secondary prophylaxis of spontaneous bacterial peritonitis

9.6.2.8 Unresolved issues in spontaneous bacterial peritonitis prophylaxis

9.7 Bacterial infections in clinical settings not unique to decompensated cirrhosis

9.8 Concluding remarks

10 Coagulation abnormality in liver cirrhosis

10.1 Background

10.2 Characteristics of coagulopathy in patients with cirrhosis

10.2.1 Platelet plug initiation and formation

10.2.2 Clotting process propagation by the coagulation cascade

10.2.3 Clot dissolution by fibrinolysis

10.3 Potential methods to assess the coagulopathy in patients with cirrhosis

10.3.1 Methods to assess primary hemostasis

10.3.2 Methods to assess secondary hemostasis

10.4 How to estimate bleeding risk and potential interventions to mitigate such risk

10.5 Beyond hemostasis: coagulopathy to predict the risk of hepatic decompensation and mortality

10.6 Concluding remarks

11 Splanchnic vein thrombosis in liver cirrhosis

11.1 Introduction

11.2 Epidemiology.

11.2.1 Prevalence and incidence of venous thromboembolism

11.2.2 Prevalence and incidence of portal vein thrombosis

11.3 Liver-related risk factors

11.3.1 Liver-related risk factors for venous thromboembolism

11.3.2 Liver-related risk factors for portal vein thrombosis

11.4 Clinical presentation of thrombosis

11.5 Prophylaxis of thrombotic complications in cirrhosis

11.6 Therapy of thrombotic events in cirrhosis

12 Splenomegaly and hypersplenism in liver cirrhosis

12.1 The normal spleen: from embryology to function

12.2 Splenomegaly in liver cirrhosis

12.3 Hypersplenism in liver cirrhosis

12.4 Spleen imaging in liver cirrhosis

12.5 Reversal of splenomegaly and management of hypersplenism

13 Pulmonary complications in liver cirrhosis

Subchapter 13.1 Portopulmonary hypertension

13.1.1 Introduction

13.1.2 Epidemiology of portopulmonary hypertension

13.1.3 Pathogenesis of portopulmonary hypertension

13.1.4 Histopathology of portopulmonary hypertension

13.1.5 Hemodynamic definition of portopulmonary hypertension

13.1.6 Clinical characteristics of portopulmonary hypertension

13.1.7 Screening of portopulmonary hypertension

13.1.8 Impact of portopulmonary hypertension on survival

13.1.9 Management of portopulmonary hypertension

13.1.9.1 General measures

13.1.9.2 Specific pulmonary arterial hypertension therapies

13.1.9.3 Endothelin receptor antagonists

13.1.9.4 Drugs targeting the NO-sGC-cGMP pathway

13.1.9.5 Prostacyclin analogs

13.1.9.6 Treatment approach

13.1.10 Liver transplantation

Subchapter 13.2 Hepatic hydrothorax

13.2.1 Introduction

13.2.2 Epidemiology of hepatic hydrothorax

13.2.3 Pathophysiology of hepatic hydrothorax

13.2.4 Diagnosis of hepatic hydrothorax.

13.2.5 Medical management options for hepatic hydrothorax.

Notes:

Description based on publisher supplied metadata and other sources.

ISBN:

0-443-21937-0

OCLC:

1527534073