Merck Manual

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Complications of Cirrhosis

Complications of Cirrhosis


Possible Cause

Swelling of the abdomen

Ascites (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 (blood clots in the veins of the legs)

Confusion and drowsiness

Hepatic encephalopathy (deterioration of brain function due to buildup of toxic substances normally removed by the liver)

Difficulty breathing

Hepatopulmonary syndrome (damage to the blood vessels in the lungs)

Portopulmonary hypertension (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 (blockage of an artery in the lung, usually by a blood clot that has traveled from another location, such as the leg)

Ascites (enough fluid accumulation in the abdomen to limit the function of the diaphragm, making breathing more difficult)

Hepatic hydrothorax (fluid accumulation in the chest outside the lungs that prevents them from inflating fully)

Fatigue and pale skin

Liver cancer (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 a minor fall or slight trauma

Symptoms of infection

Leukopenia (reduced number of white blood cells)

Jaundice (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

Impaired processing of bile

Rectal bleeding

Varicose veins in the rectum (rectal varices)

An enlarged spleen (splenomegaly)

Portal hypertension (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