Cirrhosis - Complications

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Highlights	Diagnosis	References
Introduction	Treatment	Ascites
Causes	Treatment of Complications	Bleeding Episodes
Symptoms	Liver Transplantation	Resources
Complications	Resources	References

Imaging Tests

Magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound are all imaging techniques that are useful in detecting and defining the complications of cirrhosis, such as ascites and hepatocellular carcinoma. These imaging tests can also provide information on the extent of liver damage.

Click the icon to see an image of an MRI scan.

Click the icon to see an image of a CT scan.

Liver Biopsy

A liver biopsy is the only definite method for confirming a diagnosis of cirrhosis. It also helps determine its cause, treatment possibilities, the extent of damage, and the long-term outlook. For example, patients with chronic hepatitis C who show no significant liver scarring when biopsied may have a low risk for cirrhosis.

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A biopsy involves a doctor inserting a thin biopsy needle, guided by ultrasound, to remove a small sample of liver tissue. Local anesthetic is used to numb the area. Patients may feel pressure and some dull pain. The procedure takes about 20 minutes to perform.

The biopsy may be performed using various approaches, including:

Percutaneous Liver Biopsy. This approach uses a needle inserted through the skin over the liver area to obtain a tissue sample from the liver. Various forms of needles are used, including those that use suction or those that cut out the tissue. This approach should not be used in patients with bleeding problems, and it must be used with caution in patients with ascites or severe obesity.

Click the icon to see an image of liver biopsy.

Transjugular Liver Biopsy. This approach uses a catheter (a thin tube) that is inserted in the jugular vein in the neck and threaded through the hepatic vein (which leads to the liver). A needle is passed through the tube, and a suction device collects liver samples. This procedure is risky but may be used for patients with severe ascites.
Laparoscopy. This procedure requires a small abdominal incision through which the doctor inserts a thin tube that contains small surgical instruments and a tiny camera to view the surface of the liver. This is generally reserved for staging liver cancer or for ascites of unknown cause.