cirrhosis
Chapter: 3
The liver heals by regeneration. If chronic injury occurs (e.g., alchoholism, chronic hepatitis, or right heart failure) then a combination of regeneration and fibrosis ensues, due to the fact that the extracellular matrix has become damaged. The regenerating cells don't know how to put themselves back together properly, so they form nodules. Bile ducts proliferate to try to drain bile from these nodules. The nodular appearance of the gross liver is then termed cirrhosis. Sometimes qualifying terms are used, such as "alcoholic cirrhosis" or "cardiac cirrhosis", depending upon the etiology. Occasionally one hears the terms "micronodular cirrhosis" and "macronodular cirrhosis". These terms refer to the gross appearance of the liver. Micronodular cirrhosis is generally considered to be of the alcoholic type, whereas macronodules are associated with chronic active hepatitis. These terms are not really very useful anymore, since other diseases besides alcoholism and hepatitis can result in a cirrhotic liver (e.g., Wilson disease, and primary biliary cirrhosis, see page 416).
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