What are the gastrointestinal and hematologic derangements that occur with cirrhosis

G Il complications result from portal hypertension (>10 mm Hg). Portal hypertension leads to the development of portosystemic venous collaterals, including esophagogastric varices. Ruptured varices with hemorrhage account for one third of the mortality in patients with cirrhosis.

Hematologic disorders include anemia, thrombocytopenia and coagulopathy. Anemia is secondary to GI bleeding, malnutrition, and bone marrow suppression. Thrombocytopenia is caused by splenic sequestration, bone marrow depression, and immune-mediated destruction. Coagulopathy is caused by decreased synthesis of clotting factors, accelerated fibrinolysis, and disseminated intravascular coagulation.

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