What tests are taken if liver cirrhosis is suspected? How is liver cirrhosis determined: modern diagnostics Laboratory diagnosis of cirrhosis

Liver cirrhosis is almost irreversible pathological process. A gastroenterologist knows how to diagnose liver cirrhosis. To do this, first of all, a thorough interview and physical examination of the patient is carried out, after which a series of laboratory research blood and urine. But the greatest diagnostic value have instrumental techniques. Cirrhosis of the liver is best visualized by ultrasound.

Preliminary diagnosis of cirrhosis at home

In order for a person to seek help from a specialist, he must have grounds, that is, complaints about the manifestation of certain unpleasant signs. At home, you can assume the presence of such a disease yourself, based on the manifestation of symptoms such as:

jaundice - acquires yellow tint Not only skin covering, but still slimy oral cavity and eyes. This process is caused by the fact that the liver begins to function improperly and produce large amounts of bilirubin;
a change in the shade of urine and feces, which develops against the background of the previous sign. Urine becomes dark brown and stool discolors to gray;
increase in the size of the front wall abdominal cavity- suggests that such a disorder has become a predisposing factor to the accumulation of fluid in the peritoneum. This process is caused by stagnation of bile in the liver ducts. In addition, discomfort and pain in the abdomen may appear when performing heavy lifting. physical activity, as well as swelling lower limbs;
loss of appetite, which causes weight loss. At the same time, the person eats normally, but the weakened liver is not able to process and absorb beneficial substances coming from food;
severe weakness - a large number of patients note a decrease in strength to such an extent that the person cannot perform even basic actions;
a depressive state, which is accompanied by sleep disturbances and indifference to everything that happens;
lack of sexual attraction to opposite sex– often indicates the presence of liver cirrhosis, because the inflammatory process can affect nearby organs of the peritoneum and pelvis;
a feeling of heaviness in the stomach and rapid satiety from food is explained by the fact that the enlarged liver puts pressure on the stomach;
acquisition by male representatives of some signs of femininity, in particular an increase in the size of the mammary glands;
constipation followed by diarrhea. In this case, the period of time for digesting food decreases. After eating, no more than an hour passes before defecation;
loss of skin moisture and elasticity. In addition to a yellowish tint, the skin may be covered with dark brown spots;
redness of the tongue and palms.

But the main symptom of liver cirrhosis with which people come to medical institution, is pain syndrome. In order to identify problems with the liver, you need to lightly press on the area of its projection, that is, in the area under the right ribs. With such a disease, a person will feel a strong nagging pain that persists for quite a long time. With a strong magnification of the affected organ, you can independently feel the contours of the liver through a thin layer of skin.

Medical diagnosis

After the patient is admitted to the hospital, he is immediately sent for examination to a gastroenterologist. The first thing a specialist should do is to get acquainted with the person’s medical history and life history. This will make it possible to determine some of the causes of such a disorder, for example, long-term alcoholism or the presence of hepatitis.

Then the doctor must interview the patient. This will help identify the presence, initial time of appearance and intensity of expression of the clinical picture. After listening to the complaints, the specialist conducts a thorough physical examination to detect external signs illness.

Such an examination must necessarily include palpation of the entire area of the anterior wall of the abdominal cavity. This measure will not only detect fluid accumulation and an increase in liver size, but also differentiate liver cirrhosis from other ailments that may have similar symptoms. For example, acute inflammatory processes in the peritoneum, gallbladder or pancreas. Such conditions require immediate surgery.

There are several ways to get cirrhosis pre-approved. They can serve as certain areas on the abdomen, which in response to palpation give increased susceptibility, pain points in the area of the right hypochondrium, as well as various ways applying pressure and studying the patient's reaction. With such an ailment, in the projection of the liver, the doctor will feel the edge of this organ - it is dense, sharp and causes pain to the person. With significant magnification, when the liver extends beyond the hypochondrium, the doctor will feel hard, tuberous formations.

It is necessary to palpate the spleen in the area under the left ribs. This disease is characterized by a slight increase in its volume. Palpation and tapping of the lower peritoneum is carried out to detect accumulated fluid in this area.

Swelling of the lower extremities is determined by the remaining finger marks after pressure.

Laboratory diagnostic techniques

To find out the extent of liver damage and determine future treatment tactics, the patient is shown laboratory methods diagnostics to determine the presence characteristic changes in blood, urine and feces.

General and biochemical blood tests are necessary to identify changes in its composition. In liver cirrhosis, an increase in the number of leukocytes is found, as well as a decrease in red blood cells and hemoglobin. They check the ability of blood to clot and the presence of indicators that indicate liver damage.

The study of urine and feces is primarily aimed at identifying changes in their shade - the main indicator of a violation normal functioning affected organ. In addition, urine tests are necessary to determine the presence comorbid disorder, since with cirrhosis of the liver, immunity decreases and a person is susceptible to frequent viral or colds.

After completing laboratory diagnostics, patients need to undergo a hardware examination.

Instrumental methods for diagnosing cirrhosis

Instrumental diagnosis of liver cirrhosis includes:

Endoscopy is a procedure for examining the surface of the abdominal organs, as well as considering the expanded venous network and the location of possible hidden bleeding which may accompany cirrhosis;
Ultrasound - will show changes in the volume of the affected organ, the presence of stagnation of blood and bile;
Laparoscopy is an endoscopic procedure to examine the liver, during which a biopsy is performed.

In addition, the radionuclide method is often used, in which isotopes are introduced into the blood and deposited in the liver cells. For cirrhosis on the screen ultrasound examination darkened spots will be visible.

However, the most informative and common diagnostic method is ultrasound for liver cirrhosis. During such an examination, the size of the affected organ is studied, the correspondence of parameters between the lobes of the liver is traced, the characteristics of the blood supply are determined, as well as the structure of the bile ducts and gallbladder.

During such a procedure, it is very important to detect specific manifestations of the disease. Ultrasound signs of liver cirrhosis are:

an increase in the size of the affected organ and pronounced uneven contours;
change in the surface - it is uneven and lumpy, due to the formation of fibrous nodes;
Availability large quantity areas with increased echogenicity, i.e. sensitivity to ultraviolet rays;
wrinkling right lobe liver - noted on late stages course of the disease;
changes in the vascular pattern, reverse blood flow in the vessels is noted;
decrease in gallbladder parameters;
detection of a large amount of fluid in the peritoneum;
splenomegaly.

It is by ultrasound examination that the diagnosis of “liver cirrhosis” is clarified and the most effective tactics for treating this disease are prescribed.

Similar materials

Alcoholic cirrhosis of the liver is a chronic disease in which healthy tissue is destroyed and replaced by fibrous cells. As a result of this, small nodules and scars form on the liver, which is why the liver cannot perform its functions normally. It is long-lasting because the main reason for the formation of the disease is long-term drinking alcoholic drinks that contain ethanol. IN international classification ICD-10 diseases, such a disorder has its own code – K70.3.

Liver cirrhosis is a disease in which the parenchymal tissue of the liver degenerates into connective tissue. Due to the loss of specialized cells, the liver loses its ability to function.

The process of degeneration of liver tissue is irreversible, but timely diagnosis of liver cirrhosis and treatment help to significantly slow down or stop the formation of scar tissue.

There are many reasons for the development of cirrhosis. To determine whether a patient is at risk, you should pay attention to his lifestyle (particular attention should be paid to the amount of alcohol consumed), occupation (in medical workers the risk of hepatitis is sharply increased), past illnesses, and medication use.

Depending on the cause of the disease, the following forms of cirrhosis are distinguished:

Sometimes, even after collecting anamnesis from the patient's family members, the cause of cirrhosis cannot be determined. In this case, cirrhosis is called cryptogenic, that is, with an unclear etiology.

When should you see a doctor?

A patient may suspect liver dysfunction based on a number of signs: nonspecific and specific. The first group implies a number of symptoms characteristic of many diseases - in this case the patient will have to thorough examination to identify specific reason ailments. Specific “liver” signs make it possible to preliminarily diagnose liver diseases.

Nonspecific symptoms:

asthenia – weakness and fatigue, accompanied by irritable or depressed mood;
significant reduction in body weight;
moderate excess of gamma globulin values in a blood test.

Specific symptoms:

Liver cirrhosis has incubation period. This means that from the onset of the disease until the appearance of the first complaints and visual signs, a period of at least, year.

At the first visual signs of symptoms, the patient should consult a doctor to prevent further development liver failure.

Usually the situation is complicated by the fact that the patient does not seek medical care and is hospitalized with an advanced form of cirrhosis. In this case, responsibility for timely diagnosis and treatment lies with the patient's relatives.

After a visual examination, the doctor questions the patient about complaints. Despite the fact that every fifth patient suffering from cirrhosis does not experience any symptoms, it is necessary to clarify such sensations as:

Typically, symptoms naturally increase after drinking alcohol or fatty, salty foods, which is an important diagnostic indicator.

Laboratory, instrumental, hardware diagnostic methods

In biochemical blood tests (fibrosis indicators, PGA index), the following indicators have values:

The PGA index value is assessed on a 12-point scale. The higher the PGA value, the greater the likelihood of fibrotic changes in the liver tissue.

After laboratory tests, instrumental and hardware tests are carried out. Usage various methods may vary at the discretion of the attending physician and the results of previous tests.

TO instrumental methods studies include:

Cirrhosis is assigned a degree depending on the degree of liver functioning: compensated (asymptomatic), subcompensated (moderate manifestation clinically) significant symptoms) or decompensated (pronounced development of liver failure).

In the case of compensated and subcompensated cirrhosis, it is possible to treat the patient on an outpatient basis; in the case of decompensated cirrhosis, hospitalization and inpatient treatment in the clinic are possible.

The diagnosis also indicates the type structural changes liver. Depending on the size and number of fibrous nodules in the liver, cirrhosis is called:

IN severe cases cirrhosis, additional diagnostics of the body are also carried out for complications. The consequences of cirrhosis can be very diverse, ranging from mental disorders and ending with the occurrence of bleeding and tumors. Complications can be avoided only with timely initiation of treatment, as well as following the doctor’s recommendations.

Hepatitis C is the most insidious disease, which you may not even be aware of for a long time and you may find out about the infection by chance while passing through general examination. A person does not suspect that he is a carrier of the virus, and the consequences this leads to are very serious.

How does the hepatitis C virus work?
How to determine the disease?
How is the virus transmitted?
Diagnosis of hepatitis C
Treatment of hepatitis C
Diet food
How to avoid contracting a dangerous disease?

For a long time it was said that the disease was incurable. Modern medical methods allow you to get rid of the disease in 90% of cases. The main thing is that the diagnosis is made on time. But the issue remains serious: according to WHO, in the next 20 years hepatitis C will become the main problem in the health care systems of many countries around the world.

How does the hepatitis C virus work?

I was probably one of those “lucky” people who had to endure almost all the symptoms of a diseased liver. For me, it was possible to compile a description of diseases in all details and with all the nuances!

The virus is quite common. It can exist in the external environment for a short time. It stays in the syringe needle for 4 days, dies within 2 minutes during boiling, and within 10 minutes with UV irradiation. It can live on different surfaces for up to several days.

The hepatitis C virus was discovered in 1989. It can easily change, so the body does not have time to produce new antibodies to fight the rebuilt virus. And the pharmaceutical industry is forced to create new forms of drugs.

The virus passes through the bloodstream into liver cells. Here it begins its activity, multiplying on a huge scale. Liver cells are destroyed and cease to perform a barrier function, freeing the blood from poisons and toxins.

During the development of the disease, not only the liver is affected, but also accompanying illnesses internal organs, metabolic disorders, changes immune system. Since the symptoms of hepatitis C do not manifest themselves in any way and the patient is not treated, the disease gradually becomes chronic. If no measures are taken, the result of the disease is cirrhosis or liver cancer.

How to determine the disease?

To treat and cleanse the LIVER, our readers successfully use Elena Malysheva’s method. After carefully studying this method, we decided to bring it to your attention.

The incubation period (from the moment of penetration into the body until infection of liver cells) lasts about 50 days. There may be no symptoms of hepatitis C. The existence of the disease becomes known when the disease ends in complete destruction of the liver.

The disease is insidious precisely because it is difficult to identify. It is usually discovered by chance, during annual survey. Signs of hepatitis C are not clearly expressed.
The disease is quite difficult to diagnose, because it may show signs of other diseases:

light and fast fatiguability, weakness,
no appetite,
sometimes there is an increase in the volume of the liver and spleen,
nausea associated with intoxication,
pain and aches in the joints,
jaundice may develop.

Antibodies appear in the body of 70% of patients almost immediately after the appearance of the virus, in 90% - after 3 months. Viral particles are detected in the blood 1-2 weeks after infection.

According to WHO, in Russia the number of people infected with this virus is 5 million. people, in the world - 500 million. Their number is steadily growing, despite the fact that this disease began to be registered only recently.

How is the virus transmitted?

Don't ruin your body with pills! The liver is treated without expensive drugs at the intersection of scientific and traditional medicine

There are only two ways of transmission: sexual and hematogenous (through blood). Bloodborne infection is the most common cause of infection:

The introduction of the virus through piercings and tattoos is most common, especially if these procedures are performed at home. Instruments are not always sterilized, and sanitary conditions are usually substandard.
During trips to manicure salons and during treatment at dentists.4. When administering drugs intravenously using shared syringes. Drug addicts are at risk.
It is possible to become infected at birth, but the risk is small.
Sexual contact is also dangerous, but the chance of becoming infected is small and amounts to 5% during unprotected intercourse. It is advisable to use condoms to protect yourself.
Using the patient's personal hygiene products: scissors, razors, toothbrushes.
Infection in medical institutions through injections during various procedures medical nature or operations.

Determining the source of infection is difficult and not always possible. As a rule, the patient cannot say with certainty how he acquired the disease.

Pregnant women with the hepatitis virus bear a child normally. Pregnancy proceeds without consequences for the baby. Most often born healthy child, but transmission of the virus cannot be completely excluded (probability – 6%).

Diagnosis of hepatitis C

Elena Nikolaeva, Ph.D., hepatologist, associate professor: “There are herbs that act quickly and act specifically on the liver, nullifying diseases. […] Personally, I know of the only drug that contains all the necessary extracts...”

Signs of hepatitis C will not make it possible to recognize the disease, so it is important to make a correct diagnosis and draw up a subsequent treatment plan. There is PCR diagnostics that can confirm the infectious nature of the disease and the presence of the virus in the blood.

To make a correct diagnosis:

It is necessary to check the blood through a series of tests: biochemical, general blood test, blood clotting test.
View the abdominal organs using ultrasound.
A liver biopsy may be needed.

Having received the necessary data, the doctor will have a complete picture of the development of the disease, determine the degree of its development, consider how damaged the diseased organ is and select optimal treatment, which is usually quite long.

The infection is not transmitted by household or by airborne droplets, it is impossible to become infected through saliva, through the use of shared utensils or clothing, during touching and kissing.

Treatment of hepatitis C

Treatment of hepatitis C in acute and chronic form has fundamental differences. At acute form The goal of treatment is to:

relieve the main symptoms of the disease,
stop further liver damage,
support the basic functions of the organ.

Perform intravenous administration physiological solutions that help remove toxins, use vitamins, choleretic drugs. Medicines are prescribed that restore the immune system. Intensive therapy is not prescribed because it is dangerous for the damaged liver.

For chronic hepatitis it is prescribed antiviral drugs(for example, Remantadine, Ribavirin). It is important to use immunomodulators (regulate the functioning of the immune system): interferons or interferon stimulators, immune correctors. They are changed according to the treatment plan. Treatment for hepatitis C is long and requires serious effort.

In Moscow and other cities there are specialized clinics where they study and treat hepatitis C. Hepatologists are looking for ways to more effectively influence the virus and try to improve the quality of life of their patients.

Diet food

Diet is important in treating any form of hepatitis. For nutrition, table N5 is usually prescribed, which contains:

lightly dried bread
soups of different composition: with vegetables, cereals, milk,
lean meat and fish,
dairy and fermented milk products,
drinks: tea, juice, compote, mineral water without gas,
fruits and dessert.

You need to give up smoked, fried, pickled, pickled, carbonated, canned foods; from foods that have a sour or spicy taste. Since the liver is under severe stress, it is no longer able to process “heavy” foods.

Vaccination is not carried out, because There is currently no vaccine. It is necessary to develop a stable viral protein to which the corresponding antibodies would be formed. Such research is underway, but since the virus can change, the problem remains unresolved.

How to avoid contracting a dangerous disease?

Prevention will help you avoid illness if you take good care of your health. The disease will pass by if:

You do not use drugs, do not take other people's needles or any other devices.
Do not use another person's personal belongings, especially those that may have blood on them ( razors, scissors).
If you are a healthcare worker, use sharps with caution and get vaccines against other types of hepatitis.
During hospital treatment, make sure that disposable instruments are opened in your presence.
Think carefully before getting a tattoo or piercing, and use specialized salons where the chances of infection are not so great.

The virus is dangerous, there is no vaccine for it, and its presence in the body leads to serious consequences. Therefore, the prognosis for the outcome of the disease is quite pessimistic.

If hepatitis C is diagnosed late, life expectancy will be reduced to 10-30 years. In addition, the quality of life will be somewhat different; you will have to limit yourself in many ways.

Therefore, check your blood for the presence of the virus once a year. This is a simple and inexpensive test, it is carried out without special indications. When the disease is discovered on early stages, then treatment methods modern medicine give a chance for recovery. Don’t forget about prevention and take care of your health.

Liver examination - diagnostic methods and tests

Nowadays, liver diseases are much more common than, for example, 100 years ago. Many factors lead to the pathology of this organ - refined, rich in fats food, sedentary lifestyle life, reception of many pharmaceuticals, sexual freedom, invasive cosmetic procedures and surgical procedures.

Despite the availability of information, quite often there are running forms diseases that are much more difficult to treat and lead to irreversible changes in the organ.

What is it based on? modern diagnostics liver diseases? What steps need to be taken to make an accurate diagnosis?

Symptoms of liver diseases

Any diagnosis begins with identifying symptoms characteristic of a particular disease. The problem is that different liver lesions give the same clinical picture, sometimes very erased, so it’s enough to just skip initial stage. What symptoms should you pay attention to:

Discomfort or feeling of heaviness in the right hypochondrium. Since the liver does not have pain receptors, pain of varying intensity can occur only with significant stretching of the organ capsule.
Yellowing of the skin and mucous membranes due to the accumulation of bilirubin in them.
Change in frequency of bowel movements, discoloration of stool.
Itching of the skin.

Liver diseases can cause a variety of disorders in other internal organs. This gives rise to many nonspecific symptoms. Nervous system reacts with insomnia or changes in sleep rhythm, decreased performance, emotional lability, memory impairment, etc. Unstable hormonal levels can provoke bone pathology (deformations of flat bones, spontaneous fractures).

As hepatocyte deficiency progresses, symptoms of intoxication may increase: decreased appetite, increased body temperature, muscle pain, nausea, vomiting and others. If any of the signs described above appear, you should consult a specialist. You need to monitor your well-being especially carefully during pregnancy.

Liver examination algorithm

In order to make a correct diagnosis and prescribe treatment, a certain algorithm is needed - a sequence of studies. The following procedure is usually recommended:

general blood test, urine test;
blood chemistry;
identifying markers viral hepatitis;
Ultrasound of the liver and abdominal organs;
fibrotest;
computed tomography, magnetic resonance imaging;
liver biopsy.

General blood analysis

This quick and affordable test can show some of the changes that are happening in the body. However, it is not specific for liver lesions. By changing the number of leukocytes one can judge the severity inflammatory process. A decrease in platelet levels indicates a malfunction of liver cells, which is more typical for viral hepatitis. The ESR indicator is the erythrocyte sedimentation rate, a nonspecific indicator of changes in the body. At a normal rate of 2–15 mm/h, it can increase significantly during pregnancy, with inflammatory diseases(hepatitis), infectious lesions.

Normal values for a general blood test vary from person to person. They depend on age, gender, and pregnancy. They can be found in the results table in each laboratory.

Blood chemistry

This study includes more than 40 basic indicators of the internal state of the body. If you have symptoms of liver damage, it is important to pay attention to the following tests: ALT, AST, alkaline phosphatase, GGTP, bilirubin.

ALT and AST (alanine aminotransferase, aspartate aminotransferase) are intracellular enzymes, the maximum amount of which is found in the liver, cardiac muscles, and skeletal muscles. They enter the bloodstream when the cell membrane is damaged. At a normal level of up to 41 U/l, ALT can increase significantly with viral, toxic hepatitis, liver cancer, and myocardial infarction. AST shows maximum values for lesions of cardio-vascular system, toxic and chronic hepatitis. Not only the absolute figure of the indicator is important, but also the ratio of the 2 enzymes.

The predominance of ALT over AST is a sign of hepatocyte destruction.

Alkaline phosphatase is found in all human organs, but the highest concentration is in the liver, bile ducts, kidneys. An increase in this enzyme is a characteristic sign of bile duct blockage. During pregnancy, the amount of alkaline phosphatase may exceed the physiological norm.

GGTP (gamma-glutamyltransferase) is an enzyme involved in the metabolism of amino acids, so its greatest concentration is in the kidneys and liver. It can be considered the most sensitive marker of cholestasis - stagnation of bile, due to the rapid increase in the concentration of the enzyme in the blood when the bile ducts are blocked. Intervals normal values GGTP varies depending on the analysis technique.

It is worth remembering that there are no specific enzymes that accurately indicate liver damage; they can exceed the norm under physiological conditions (pregnancy), alcohol abuse, diseases of other organs, and intense physical activity.

To the reasons for the increase total bilirubin include: liver damage (toxic, viral), cirrhosis, increased breakdown of red blood cells ( hemolytic anemia), cholestasis ( cholelithiasis). It is necessary to separate direct and indirect bilirubin. The destruction of red blood cells increases indirect, hepatic causes affect the direct. The normal values depend on the analysis method and the test systems used. They are usually presented in table form on the form for issuing analysis results.

Markers of viral hepatitis

Antibodies can be divided into 2 types: IgM and IgG. The first indicate acute stage process, the second – about a past infection and persist throughout life.

For hepatitis A, it is enough to determine IgM. The most accurate indicator for viral hepatitis B is HBeAg. This nuclear antigen indicates the presence of active reproduction of the virus in hepatocytes and high blood contamination. Hepatitis C is also detected.

It is important to monitor the increase in antibody titer over time. Since viruses can pass from mother to child, you need to be tested for hepatitis before pregnancy.

This research requires preparation. 3 days before the ultrasound, you should exclude foods that cause flatulence from your diet, and if necessary, do a cleansing enema.

An ultrasound examination shows the size of the liver and gallbladder. Diffuse or focal lesions can be determined.

The first include:

hepatosis;
acute and chronic hepatitis;
cirrhosis.

Hepatosis is associated with the accumulation of fat in liver cells. Due to the different density of hepatocytes and fat droplets, the picture of the liver becomes “variegated”. As the disease progresses, functionally active tissue is replaced by connective tissue, so signs of fibrosis are clearly visible on ultrasound. The size of the organ increases due to both lobes, the edge is rounded.

Regardless of the type of hepatitis (viral, toxic), the ultrasound picture is nonspecific. The size of the lobes may increase, the shape of the edges may change, but the density remains within normal limits. Over time, areas of hypoechogenicity may appear.

Signs of cirrhosis can be direct and indirect. To make a diagnosis, 3 direct or a combination of 2 direct and 2 indirect symptoms are sufficient. More details about them in the table.

Focal changes in the liver are visible more clearly than diffuse ones. You can immediately identify areas increased density(hemangioma, adenoma, cancer metastases, calcifications), reduced echogenicity (sarcoma, lymphoma, abscess, hematoma).

The information content of ultrasound is quite high, but the lack of specific signs makes it impossible to make a diagnosis using only one examination method.

Fibrotest

In modern laboratories, a new non-invasive method for diagnosing liver lesions is being actively introduced - fibrotest. It is an alternative to biopsy. The main task is to determine the stage of fibrosis and necroinflammatory activity. Indications for fibrotest may include: chronic hepatitis. Since 2008, in France, this study has been recognized as a reliable method for determining hepatitis C in an advanced stage. Fibrotest is safe and can therefore be used during pregnancy.

MRI, CT scan of the liver

Non-invasive liver studies include computed tomography and magnetic resonance imaging. These techniques allow you to obtain a picture of the organ in the form of sections with a step of 5–10 mm. To identify the most common focal pathology, it is used contrast enhancement. The methods make it possible to determine any deviations from the norm in size and structure. Among the shortcomings we can highlight high cost studies, presence of contraindications (pregnancy, presence of a pacemaker).

Liver biopsy

This method is used in cases where other methods are not informative enough. Since this procedure is quite traumatic and is surgical intervention, they resort to it only in extreme cases. There are several techniques for performing a biopsy:

Standard – using a needle, a small section of the patient’s liver is taken;
Laparoscopic - a camera is inserted into the abdominal cavity along with a needle for better visualization of the process;
Transvenous - through venous catheter The instrument moves through the vessels to the liver, where material is collected for research.

Biopsy is last method For differential diagnosis liver damage.

Accurate laboratory diagnosis of liver diseases, modern methods instrumental examination, timely contact with a specialist are factors contributing to the early detection of pathology.

The less time passes from the onset of the disease to the start of treatment, the greater the chance of a positive result!

Determining the disease in the early stages is the key successful treatment. Often, many diseases are characterized by an asymptomatic onset, so even cirrhosis of the liver is detected already in advanced stages. To prevent this from happening, our article will tell you about possible methods determining the development of the disease.

Methods for diagnosing liver cirrhosis

What does blood biochemistry show in cirrhosis:

Increased bilirubin levels.
Significant increases in potassium, sodium, creatinine and urea.
Increased levels of ALT and AST enzymes.
Decreased albumin.
Increased alkaline phosphatase activity.

If necessary, a blood test is carried out for the presence of serological signs of viral hepatitis, because this is the cause of the development of cirrhosis in most cases.

If there is a suspicion of degeneration of hepatocytes (liver cells) into adipose or connective tissue, a procedure is performed.

The procedure allows you to accurately determine the nature of the pathology, and to finally confirm the diagnosis and exclude the possibility of another disease, additional studies are carried out.

Instrumental research

The capabilities of modern medicine have been significantly expanded, because many procedures make it possible to detect negative changes in the body long before the development of irreversible processes.

Abdominal ultrasound

Painless and very affordable way liver checks. A complete examination of the abdominal organs is usually performed.

Allows you to see changes in organ size, heterogeneity of structure and foci of inflammation. In addition, the signs and patency of the bile ducts are checked.

If necessary, the same equipment can be used to conduct Dopplerography and check the condition of blood vessels and arteries, blood flow speed and possible deviations in organ supply.

CT and MRI

Modern progressive methods are computer examinations.

During such procedures, there is a chance to check the functionality of other organs, as well as the operation of internal systems.

The only difficulty is choosing a specialist and a clinic, as well as the financial side of the issue.

Radionuclide examination and radiography

Radionucleic acid method - relatively the new kind research, which is still inaccessible to the majority of the population.

The essence of the method is the introduction of a small amount of an isotope substance into the human body. The radiation will be detected special device, the data of which will allow you to assess the functioning of the liver and other organs.

The method is extremely informative and eliminates the possibility of errors and incorrect diagnoses due to the “human factor”.

Radiography of the liver allows you to clearly determine the contour of the organ, possible stones and formations, as well as changes in size. The effectiveness of the method is enhanced by introduction into the vena cava contrast agent. This allows you to determine sufficient blood supply and identify possible pathologies venous and arterial network of the liver.

How to determine the disease at home?

In the early stages of the disease, pathological changes are very difficult to determine independently. Usually develops very slowly and gives characteristic symptoms already at critical stages.

At the same time, knowledge of the characteristic signs of this disease will help you consult a doctor in a timely manner, which increases the effectiveness of further therapy.

Alarming symptoms of cirrhosis:

Increased drowsiness and fatigue.
Nervousness, behavioral disturbances.
Yellowing of the skin and whites of the eyes.
Increase in abdominal volume due to development (edema).
Digestive disorders.
Pain in the right side (increases after eating).
Heavy nosebleeds or menstrual bleeding.
Redness of the surface of the palms and soles (palmar erythema).
Vascular pattern on the abdomen.
Thickening of the phalanges of the fingers (so-called “drum sticks”).
Decreased appetite, weight loss.

Development is preceded by many factors, and the disease very often progresses asymptomatically.

If there is any suspicion of liver dysfunction, you should consult a specialist - a hepatologist. Special examinations and new techniques for examining internal organs will help diagnose the disease in the early stages.

– a disease characterized by the degeneration of parenchymal liver tissue into fibrous connective tissue. Accompanied dull ache in the right hypochondrium, jaundice, increased pressure in the portal vein system with bleeding (esophageal, hemorrhoidal), ascites, etc., characteristic of portal hypertension. The disease is chronic. In the diagnosis of liver cirrhosis, the decisive role is played by ultrasound, CT and MRI data of the liver, biochemical test values, and liver biopsy. Treatment of liver cirrhosis involves strict abstinence from alcohol, diet, and taking hepatoprotectors; in severe cases - donor liver transplantation.

General information

Cirrhosis is characterized by the appearance of connective tissue nodes in the liver tissue, the proliferation of connective tissue, the formation of “false” lobules. Cirrhosis is distinguished by the size of the developing nodules into small nodular (many nodules up to 3 mm in diameter) and large nodular (nodules exceeding 3 mm in diameter). Changes in the structure of the organ, unlike hepatitis, are irreversible, thus, cirrhosis of the liver is an incurable disease.

Among the causes of liver cirrhosis, alcohol abuse is the leading cause (from 35.5% to 40.9% of patients). In second place is viral hepatitis C. Men develop cirrhosis more often than women, which is associated with a greater prevalence of alcohol abuse among men.

Etiology and pathogenesis

In the vast majority of cases, the cause of liver cirrhosis is alcohol abuse and viral hepatitis B and C. Regular use alcohol in doses of 80-160 ml of ethanol leads to the development of alcoholic liver disease, which in turn progresses with the occurrence of cirrhosis. Among people who abuse alcohol for 5-10 years, 35% suffer from cirrhosis.

Diagnosis of liver cirrhosis

The diagnosis is made by a gastroenterologist or hepatologist based on a combination of data from the anamnesis and physical examination, laboratory tests, functional tests, instrumental diagnostic methods.

IN general analysis blood with cirrhosis of the liver, anemia, leukocytopenia, thrombocytopenia may be observed (usually this indicates the development of hypersplenism), coagulogram data show a decrease in the prothrombin index. A biochemical blood test reveals an increase in the activity of liver enzymes (Alt, AST, alkaline phosphatase), an increase in the content of bilirubin (both fractions), potassium and sodium, urea and creatinine in the blood, and a decreased level of albumin. Tests are also carried out to detect antibodies to hepatitis viruses and determine the content of alpha-fetoprotein.

Instrumental diagnostic methods that help complement the clinical picture of cirrhosis include ultrasound of the abdominal organs (changes in the size and shape of the liver, its sound permeability are noted, signs of portal hypertension and changes in the spleen are also visible). Computed tomography of the abdominal cavity allows you to visualize the liver, blood vessels, and bile ducts in even more detail. If necessary, MRI of the liver and Doppler of the liver vessels are performed.

For a final diagnosis and choice of treatment tactics, a liver biopsy is necessary (allows one to assess the nature of morphological changes and make an assumption about the causes of the development of cirrhosis). As auxiliary methods for identifying the cause of this disease, methods are used to identify enzyme deficiencies, examine indicators of iron metabolism, and the activity of proteins - markers of metabolic disorders.

Treatment of liver cirrhosis

Therapy for patients with liver cirrhosis should solve the following problems: stop the progressive degeneration of liver tissue, compensate for existing functional disorders, reduce the load on the veins of collateral blood flow, prevent the development of complications.

All patients are prescribed special diet and a recommended diet. In case of cirrhosis in the compensation phase, it is necessary to eat fully, maintain a balance of proteins, fats and carbohydrates, take the necessary vitamins and microelements. Patients with liver cirrhosis should categorically avoid drinking alcohol.

Whenever high risk development of encephalopathy, liver failure, patients are transferred to a diet with a reduced protein content. For ascites and edema, patients are advised to avoid salt. Recommendations for the regimen: regular meals, 3-5 times a day, exercise physical exercise, avoiding physical inactivity (walking, swimming, exercise therapy). For patients suffering from liver cirrhosis, many medicines. It is also advisable to limit your consumption medicinal herbs and biologically active additives to food.

Drug therapy for liver cirrhosis consists of correcting symptoms associated with metabolic disorders and the use of hepatoprotectors (ademetionine, ornithine, ursodeoxycholic acid). Also used are drugs that help remove ammonia and normalize intestinal flora (lactulose), enteroseptics.

In addition to the direct treatment of cirrhosis, drug therapy prescribed to combat the pathology that caused the degeneration of liver tissue: antiviral interferon therapy, hormone therapy autoimmune conditions, etc.

With severe ascites, paracentesis is performed and excess fluid is pumped out of the abdominal cavity. To form an alternative blood flow, shunting of collateral vessels is performed. But the cardinal surgical method for treating cirrhosis is donor liver transplantation. Transplantation is indicated for patients with severe course, rapid progression, high degree degeneration of liver tissue, liver failure.

Prevention and prognosis

Prevention of liver cirrhosis consists of limiting alcohol intake, timely and adequate treatment viral hepatitis and other diseases that contribute to the development of cirrhosis. Also recommended healthy balanced diet and an active lifestyle.

Cirrhosis is an incurable disease, but if detected in the early stages, it can be successfully eradicated etiological factor and following dietary and lifestyle recommendations, the survival prognosis is relatively favorable. Alcoholic cirrhosis with continued alcohol abuse is prone to rapid decompensation and the development of dangerous complications.

Patients with developed ascites have a survival prognosis of about 3-5 years. When bleeding occurs from varicose veins of collateral blood flow, the mortality rate in the first episode is about 30-50%. Development hepatic coma leads to death in the vast majority of cases (80-100%).