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Short Notes on Cirrhosis 2018 - Dr Mark Burgin

10/04/18. Dr. Mark Burgin BM BCh (oxon) MRCGP considers the elements that should be included in a primer for clinical negligence cases involving liver cirrhosis.

The liver contains enzymes that inactive toxins in food and it syntheses important chemicals that all cells need to function and cirrhosis (scarring) can replace 70% of the liver before the problem is recognised.

The toxins are secreted into the bile so that when damage to the liver cells causes swelling and inflammation the waste product bilirubin remains in the blood causing the patient to turn yellow.

Many cases of Hepatitis are subclinical and liver function tests can return to normal after the inflammation has settled even though the liver is failing.

There has been a four times increase in the numbers of liver deaths in the UK since 1970 (most cirrhosis), thought to be due to increased obesity and alcohol consumption. (1)

Liver function tests

The liver function tests LFT are based upon the release of liver enzymes when the cells are damaged but will not show either how much reserve there is or previous damage although an AST/ALT ratio of ≥1 is used as an indication...

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