Liver Shrinkage (Cirrhosis): Symptoms, Complaints, Signs

Liver cirrhosis is usually asymptomatic (without symptoms) in the early stages: latent cirrhosis (about 15-25%).

The following symptoms and complaints may indicate manifest cirrhosis (liver shrinkage):

  • Limited performance and rapid fatigability (60-80%).
  • Abdominal discomfort (50-60%)
  • Anemia (anemia)
  • Ascites (abdominal fluid) and edema (water retention) in the legs.
  • Dupuytren’s contractures (synonyms: Dupuytren’s contracture, Dupuytren’s disease) – nodular, cord-like hardening of the palmar aponeurosis (tendon plate in the palm, which is the continuation of the tendon of the long palmar muscle) with increase in the coarse connective tissue, which can lead to flexion contracture of the finger joints (fingers are forced to bend and can be stretched again only with difficulty or not at all).
  • Fever
  • Caput medusae (Latin: head of Medusa) – varices (visible extension of tortuous veins) in the region of the navel – due to bypassing the hepatic stroma via the portocaval anastomosis present in the skin veins of the umbilical region (venae paraumbilicales) – as a result of blood stasis due to portal hypertension (portal hypertension).
  • Banknote skin (synonym: dollar bill skin) – reminiscent of banknotes, characterized by innumerable finest vascular dilatations.
  • General bleeding tendency / tendency to hematomas (about 10%).
  • Weight loss (due to malnutrition and anorexia (loss of appetite)) (30-40%).
  • Skin atrophy with telangiectasias (visible dilatations of superficially located smallest blood vessels).
  • Hypercholesterolemia – increased cholesterol levels in the blood.
  • Icterus – yellowing of the skin.
  • Lacquer lips – smooth, lacquer red lips.
  • Lacquer tongue – especially red and uncoated tongue.
  • Melanosis – slowly progressive darkening of the skin.
  • Meteorism (bloated belly)
  • Nevi aranei (spider nevus)
  • Nail symptoms:
    • Leukonychia (white nails: spot, streak or patchy white areas of the nails).
    • Drumstick fingers – fingers distended at the end links.
    • Watch glass nails – bulging nails.
    • White nails (lunula (lat.: “small moon”) no longer delimitable).
  • Palmar erythema – red coloration of the palms.
  • Plantar erythema – red coloration of the sole of the foot.
  • Peripheral edema – accumulation of water in the tissues of the legs.
  • Plantar erythema – red discoloration of the soles of the feet.
  • Pruritus (itching)
  • Psychological lability
  • Restless Legs Syndrome (RLS) – restless legs syndrome.
  • Sleep disorders
  • Pain in the right upper abdomen
  • Spider naevi (hepatic asterisks) – small vessels that converge in a star shape on the upper body and face.
  • Steatorrhea – depositing greasy stools.
  • Xanthelasmata – fatty deposits around the skin of the eyes.
  • Xanthomas – fat deposits around the joints.
  • Man:
    • Gynecomastia – enlargement of the mammary gland in men.
    • Testicular atrophy – shrinkage of the testicle.
    • Loss of libido and potency (25-35%)
    • Loss of body hair on the chest and abdomen (belly baldness, feminization of the hair type in men).
  • Woman:
    • Cycle irregularities such as oligomenorrhea (the interval between periods is > 35 days and ≤ 90 days, i.e. the period occurs too infrequently) to secondary amenorrhea (absence of menstruation: > 90 days).
    • Virilization – expression of male sexual characteristics or a male phenotype in women.