History
The first description of a cirrhotic liver appeared in a drawing by Leonardo Da Vinci from 1508 in Florence. The drawing was based on an autopsy to highlight the vascular anatomy of the liver.
Origin of disease
As mentioned above, the causes of liver cirrhosis are very diverse. The most common cause in industrialized countries, with about 50% of cirrhoses, is alcohol abuse. The second most common cause of cirrhosis is hepatitis.
Here the frequency is about 20-25%. Hepatitis C is the form of hepatitis that most frequently leads to cirrhosis of the liver, as hepatitis C is chronic in 85% of cases, resulting in destruction of liver tissue that lasts for decades. In developing countries, the causes of cirrhosis are clearly reversed.
Here, over 90% of cirrhosis is the result of hepatitis. This can be explained mainly by the lack of hygiene. At the cellular level, a so-called necrosis of the liver cells occurs.
Necrosis describes a process in which cells are irreversibly damaged. These cell necroses are caused by viruses or toxins. The destruction of liver cells causes the immune system with its many cells to be activated by messenger substances and thus, through the constant immune reaction, a connective tissue reconstruction of the liver takes place.
This leads to tissue necrosis with the formation of so-called regenerate nodes and connective tissue septums. These remodelling processes interrupt the natural blood and bile flow through the liver. The interruption of the blood and bile ducts leads to blood and bile congestion in the liver, which in severe cases can spread to the body.
The high pressure caused by the congestion in the liver is called portal hypertension (high blood pressure of the liver). In portal hypertension, the blood accumulates in the abdominal organs of the body and in the so-called collateral vessels (bypass circulation). The most feared complication of liver cirrhosis is esophageal varicose vein bleeding (varicose veins in the esophagus).
The varices are caused by the congested blood of the liver looking for other ways to get back to the right ventricle. These varicose veins are under high pressure and can tear, for example, if you cough too much. The rupture of these varicose veins is considered one of the most serious emergencies in medicine, as a great deal of blood can be lost very quickly. Meanwhile, cirrhosis of the liver belongs to the preliminary stage of liver cancer, the so-called hepatocellular carcinoma (HCC).
