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Early in the course of cirrhosis, few manifestations are present. The liver may be palpable and tender. A dull aching pain may be present in the ( upper right quadrant, upper left quadrant, lower right quadrant, lower left quadrant ) of the abdomen. Weight loss, weakness, anorexia, and bowel disruption may occur. As cirrhosis progresses, however, manifestations relate to liver cell failure and portal hypertension.
( Portal hypertension, Ascites ) is the shunting of blood to lower-pressure vessels. Some of the collateral veins that are affected are located in the esophagus, causing large, thin-walled, esophageal ( varices, ascites, aneurysms, breaks ). These vessels can rupture and cause massive hemorrhaging, especially if the liver damage causes ( thrombocytopenia, leukopenia, anemia ) and impaired production of ( clotting factors, platelets ).
In addition to being shunted to the esophagus, blood can be shunted to the ( spleen, kidneys, abdominal wall, heart ), causing it to enlarge. Enlargement of the ( spleen, kidneys, lungs, heart ) can lead to anemia, leukopenia, and thombocytopenia due to increased destruction of blood cells.
Because portal hypertension increases hydrostatic pressure, it can also cause ( ascites, varices ), which is the accumulation of plasma-rich fluid in the abdominal cavity. In relation to this is the ability to develop ( spontaneous bacterial peritonitis, spontaneous hyperthermia, acute kidney failure ).
Cirrhosis can even cause psychological manifestations. Without functioning liver tissue, ( ammonia, bilirubin ) is not converted to uera, causing it to build up in the blood and cause ( portal systemic encephalopathy, portal systemic neuropathy, portal systemic peritonitis, portal systemic meningitis ). The primary manifestation of this is ( asterixis, Parkinsonism, Tourette's, aphasia ), which is a muscle tremor that interferes with the ability to maintain a fixed position of the extremities.
