Assessment and Diagnostic Findings
The extent of liver disease and the type of treatment are determined after
reviewing the laboratory findings. Because the functions of the liver are
complex, there are many diagnostic tests that may provide information about
liver function. In severe parenchymal liver dysfunction, the serum albumin level decreases.
Enzyme tests indicate liver cell damage: serum alkaline phosphatase, AST,
ALT levels increase, and the serum cholinesterase level may decrease Bilirubin tests are performed to measure bile excretion or bile retention;
elevated levels can occur with cirrhosis and other liver disorders. Prothrombin time is prolonged. Ultrasound scanning is used to measure the difference in density of
parenchymal cells and scar tissue. CT, MRI, and radioisotope liver scans give information about liver size and
hepatic blood flow and obstruction. Diagnosis is confirmed by liver biopsy.Medical Management
The management of the patient with cirrhosis is usually based on the presenting
symptoms. For example, antacids are prescribed to decrease gastric distress and
minimize the possibility of GI bleeding. Vitamins and nutritional supplements promote healing of damaged liver cells
and improve the general nutritional status. Potassium-sparing diuretics
(spironolactone [Aldactone], triamterene [Dyrenium]) may be indicated to
decrease ascites, if present ; Preliminary studies indicate that colchicine, an antiinflammatory agent used to
treat the symptoms of gout, may increase the length of survival in patients with
mild to moderate cirrhosis. Colchicine is believed to reverse the fibrotic
processes in cirrhosis, and this has improved survival