Decompensated liver diseases [ DKLD]

1. Acute hepatitis
2. Liver enlargement and tenderness
3. +/- jaundice
4. Chronic liver:
   • Sallow or jaundiced complexion
   • Extremity muscle atrophy
   • Dupuytren’s contracture
   • Palmar erythema
   • Cutaneous spider nevi
   • Distended abdomen with a fluid wave
   • Enlarged veins on the surface of the abdomen (caput medusae)
   • Asterixis
   • Extraordinary bruising or other signs of bleeding diathesis (in liver failure)
5. Cirrhosis
   1. Ascites
   2. Spontaneous Bacterial Peritonitis
   3. Hepatic Encephalopathy
   4. Hepato-renal syndrome
   5. Coagulopathy
6. Liver Failure
   • Complications of acute liver failure:
   • Hepatic encephalopathy
   • Hepatorenal syndrome
   • Coagulopathy
   • Other complications:
   • Electrolyte imbalances
   • Cerebral edema
   • Intracranial hypertension Consequences:
   • Negative nitrogen balance (due to catabolic nature of liver failure)
   • Immunodeficiency