liver and gallbladder disorders
Cirrhosis of the Liver
Diagnosis of Cirrhosis
Blood tests, including liver tests Sometimes imaging tests (for example, ultrasound) Sometimes liver biopsy Doctors usually suspect cirrhosis based on the person's symptoms, results of the physical examination, and a history of risk factors for cirrhosis such as chronic excessive alcohol use. Often during the physical examination, a doctor notices problems that typically result from cirrhosis, such as an enlarged spleen, a swollen abdomen (indicating Ascites ), Liver Blood Tests are done. Results are often normal because these tests are relatively insensitive and the liver can function for a long time despite damage. The liver can carry out essential functions even when its function is reduced by 80%. A complete blood count (CBC) is done to check for anemia, low platelet count, and other blood abnormalities. Blood tests are done to check for hepatitis and often other possible causes. Imaging Tests of the Liver and Gallbladder can identify advanced cirrhosis but often does not identify early cirrhosis. Ultrasonography, computed tomography (CT), or magnetic resonance imaging (MRI) can show whether the liver has shrunk or its structure is abnormal, suggesting cirrhosis. These tests can detect portal hypertension and ascites. Specialized imaging tests (transient elastography, magnetic resonance elastography, and acoustic radiation force impulse imaging) help detect early cirrhosis. If the diagnosis is still uncertain, a Biopsy of the Liver (removal of a tissue sample for examination under a microscope) can be done to confirm it. Biopsy and sometimes blood tests can also help doctors determine the cause of cirrhosis. If cirrhosis is confirmed, ultrasonography with or without a blood test that could indicate a liver tumor (alpha fetoprotein) are done every 6 months to check for liver cancer. If ultrasonography detects abnormalities that suggest cancer, doctors do magnetic resonance imaging (MRI) or CT after injecting a contrast agent. When cirrhosis is confirmed, endoscopy of the upper digestive tract (inserting a flexible viewing tube) may be needed to check for varices, particularly when there are signs of portal hypertension in blood and imaging tests and the patient is not a candidate for medication to decrease portal hypertension. This endoscopy test is repeated every 2 to 3 years. It is done more often if varices are detected. Blood tests that assess the liver are done regularly. 