Table: Complications of Cirrhosis - Merck Manuals Consumer Version

Complications of Cirrhosis

Symptom	Possible Cause
Swelling of the abdomen	Ascites Ascites Ascites is the accumulation of protein-containing (ascitic) fluid within the abdomen. Many disorders can cause ascites, but the most common is high blood pressure in the veins that bring blood... read more (accumulation of fluid within the abdomen)
Abdominal discomfort, often with fever	Spontaneous bacterial peritonitis (infection of fluid that has accumulated within the abdomen)
Calf pain or swelling	Deep vein thrombosis Deep Vein Thrombosis (DVT) Deep vein thrombosis is the formation of blood clots (thrombi) in the deep veins, usually in the legs. Blood clots may form in veins if the vein is injured, a disorder causes the blood to clot... read more (blood clots in the veins of the legs)
Confusion and drowsiness	Hepatic encephalopathy Hepatic Encephalopathy Hepatic encephalopathy is deterioration of brain function that occurs in people with severe liver disease because toxic substances normally removed by the liver build up in the blood and reach... read more (deterioration of brain function due to buildup of toxic substances normally removed by the liver)
Difficulty breathing	Hepatopulmonary syndrome Hepatopulmonary Syndrome Hepatopulmonary syndrome is low levels of oxygen in the blood caused by widening (dilation) of the small arteries of the lungs that occurs in people with liver disease. Three abnormalities develop... read more (damage to the blood vessels in the lungs) Portopulmonary hypertension Portopulmonary Hypertension Portopulmonary hypertension is a condition in which blood pressure is elevated in the arteries of the lungs, called the pulmonary arteries (pulmonary hypertension), and in the portal vein (which... read more (high blood pressure in the lungs' arteries due to high blood pressure in the portal vein, which carries blood from the intestine to the liver) Pulmonary embolism Pulmonary Embolism (PE) Pulmonary embolism is the blocking of an artery of the lung (pulmonary artery) by a collection of solid material brought through the bloodstream (embolus)—usually a blood clot (thrombus) or... read more (blockage of an artery in the lung, usually by a blood clot that has traveled from another location, such as the leg) Ascites Ascites Ascites is the accumulation of protein-containing (ascitic) fluid within the abdomen. Many disorders can cause ascites, but the most common is high blood pressure in the veins that bring blood... read more (enough fluid accumulation in the abdomen to limit the function of the diaphragm, making breathing more difficult) Hepatic hydrothorax Pleural Effusion Pleural effusion is the abnormal accumulation of fluid in the pleural space (the area between the two layers of the thin membrane that covers the lungs). Fluid can accumulate in the pleural... read more (fluid accumulation in the chest outside the lungs that prevents them from inflating fully)
Fatigue and pale skin	Liver cancer Hepatocellular Carcinoma Hepatocellular carcinoma is a cancer that begins in the liver cells and is the most common of the primary liver cancers. Having hepatitis B or hepatitis C or fatty liver disease, or drinking... read more (can also cause weight loss) Anemia due to any of the following: Bleeding An enlarged spleen Undernutrition with a deficiency of folate, iron, or vitamin B12 Chronic alcohol abuse, which can interfere with the production of blood cells
Reduced urination and difficulty breathing	Hepatorenal syndrome (kidney failure due to liver failure)
Fractures, often due to slight trauma such as a minor fall	Osteoporosis Osteoporosis Osteoporosis is a condition in which a decrease in the density of bones weakens the bones, making breaks (fractures) likely. Aging, estrogen deficiency, low vitamin D or calcium intake, and... read more , caused in part by vitamin D deficiency; Vitamin D Deficiency Vitamin D deficiency is most commonly caused by a lack of exposure to sunlight. Some disorders can also cause the deficiency. The most common cause is lack of exposure to sunlight, usually when... read more falls, caused in part by loss of muscle tissue (sarcopenia)
Symptoms of infection	Leukopenia (reduced number of white blood cells)
Jaundice Jaundice in Adults In jaundice, the skin and whites of the eyes look yellow. Jaundice occurs when there is too much bilirubin (a yellow pigment) in the blood—a condition called hyperbilirubinemia. (See also Overview... read more (yellowish discoloration of the skin and whites of the eyes)	Impaired processing of bilirubin (a waste product formed when old or damaged red blood cells are broken down)
Easy bruising or a tendency to bleed easily A reddish purple rash of tiny dots or larger splotches, which indicate bleeding in the skin	An enlarged spleen, which traps platelets (needed to help blood clot) Chronic alcohol abuse, which can interfere with the production of platelets A deficiency of vitamin K Reduced production of clotting factors (proteins that help blood clot) by the damaged liver
Itching (pruritis) and small yellow deposits of fat in the skin or eyelids (jaundice)	Impaired processing of bile
Rectal bleeding	Varicose veins in the rectum (rectal varices)
An enlarged spleen (splenomegaly)	Portal hypertension Portal Hypertension Portal hypertension is abnormally high blood pressure in the portal vein (the large vein that brings blood from the intestine to the liver) and its branches. Cirrhosis (scarring that distorts... read more (high blood pressure in the vein that carries blood to the liver)
Light-colored, soft, bulky, oily-looking, and unusually foul-smelling stools (steatorrhea)	Impaired absorption of fats
Vomiting of blood	Varicose veins at the lower end of the esophagus (esophageal varices) or in the stomach (gastric varices) due to portal hypertension