<unk>  is a consequence of chronic liver disease characterized by the replacement of liver tissue by fibrotic scar tissue as well as regenerative nodules, leading to progressive loss of liver function. The first description of the clinical picture and pathologic appearance of<unk> , was published in 1761. René Laennec coined the term<unk> " in 1819. The word<unk> " was derived from the Greek term kirrhos, meaning "tawny" (to describe the orange-yellow or tan color of the diseased liver). The pathological hallmark of<unk>  is the development of scar tissue which leads to replacement of normal liver parenchyma, leading to blockade of portal blood flow and disturbance of normal liver function. When fibrosis of the liver reaches an advanced stage where distortion of the hepatic vasculature also occurs, it is termed as<unk>  of the liver. The pathogenesis of<unk>  involves inflammation, hepatic stellate cell activation, angiogenesis and fibrogenesis.  Fibrosis eventually leads to formation of septae that grossly distort the liver architecture which includes both the liver parenchyma and the vasculature, accompanied by regenerative nodule formation.The most common cause of<unk>  in the United States is Hepatitis C and chronic, heavy alcohol use, while the most common cause of<unk>  worldwide and in Asian countries is the hepatitis virus. The devastating complications include complete liver failure or the development of hepatocellular carcinoma. Other complications include portal hypertension, ascites, jaundice, itching, esophageal varices, spontaneous bacterial peritonitis, hepatic encephalopathy, hepatorenal syndrome, hepatopulmonary syndrome and cardiomyopathy. Prognosis depends on the causes, existing complications and a variety of factors which make the prediction of life expectancy questionable. Liver<unk>  may present with non specific constitutional symptoms such as fever, anorexia, fatigue, nausea, vomiting, menstrual irregularities and testicular atrophy. Patients with decompensated<unk>  may develop complications and present with jaundice, increase in abdominal girth due to ascites, pruritus, hematochezia, melena and confusion due to hepatic encephalopathy. Patients with<unk>  usually present with signs of jaundice, palmar erythema, spider angiomata, gynaecomastia and alteration of mental status arising due to complications of<unk> . Abdominal examination may show signs of abdominal distension, caput medusae, splenomegaly and flank dullness on percussion. On ultrasonography, changes in the liver contour and increased nodularity may be evident. The echo texture may appear coarse along with an increase in echogenecity from focal fatty changes and irregular appearing areas. USG may also be used to screen for hepatocellular carcinoma, portal hypertension and Budd-Chiari syndrome. The gold standard diagnostic test for<unk>  in developing countries is liver biopsy, although it is rarely necessary for diagnosis or treatment. In developed countries, Fibroscan is fast replacing liver biopsy as the gold standard diagnostic modality. The change that<unk>  causes to the liver is irreversible, therefore treatment is mostly centered on ameliorating the complications of<unk>  such as ascites, hepatic encephalopathy, spontaneous bacterial peritonitis, esophageal varices and hepatorenal syndrome. Chronic constitutional symptoms such as pruritus, hypogonadism, osteoporosis and anorexia must be treated in patients. Maintenance of adequate nutrition (especially protein intake) is extremely important in<unk>  patients. The underlying cause of<unk>  needs to be managed and the treatment varies depending upon the cause of<unk> . Patients with decompensated liver<unk>  are  usually candidates for liver transplantation. Liver transplantation may be carried out based on MELD score and assessment of the patient’s quality of life, absence of contraindications and disease severity. In cases where transplantation is contraindicated, a patient may undergo the TIPS procedure.  A transjugular intrahepatic portosystemic shunt, also TIPS, is an artificial channel in the liver from the portal vein to a hepatic vein, created via the jugular vein. The main purpose of the TIPS procedure is to decompress the portal vein which would in turn help to prevent rebleeding from varices, and also prevent ascites formation. TIPS is used to treat portal hypertension which is often due to<unk> .
Cirrhosis
Hepatitis
Fatty liver
Alcoholic liver disease
Non-alcoholic fatty liver disease
Chronic liver disease
Hepatic failure
Hepatocellular carcinoma stagin