Hepatocellular carcinoma (liver cancer)

Liver cancer is the growth and spread of abnormal cells within the liver. The symptoms of liver cancer usually appear only after the disease has reached advanced stages. It may be discovered by chance or when the patient complains of symptoms caused by the tumor, abdominal pain, jaundice, nausea or symptoms of liver failure.

The cancer that develops inside the liver is called primary liver cancer. It is more common in areas with higher numbers of hepatitis B and hepatitis C such as in East Asia and sub-Saharan Africa the cure:

The treatment of liver cancer depends on:

* Liver condition

* The size and number of cancers in the liver

* If the cancer has spread to the outside of the liver

* Age and general state of health.

The Treatment options are: Liver Transplant if the cancer did not spread outside the liver.

Surgery and cancer resection If cancer is detected early and the rest of the liver is intact and there is no fibrosis in the liver.

Injection of chemical drugs directly into the tumor


Sorafenib is an oral chemotherapy drug used in the treatment of hepatocellular carcinoma.


Fluid retention (ascites)

Is a fluid accumulation in the peritoneal cavity that is separated from the chest and diaphragm,

The causes of ascites can be diagnosed by blood test and ultrasound.

Patients with abdominal ascites suffer from increased abdominal weight, pressure, and shortness of breath due to increased pressure on the diaphragm.

The treatment is salt restrictions and diuretics.

For patients with severe ascites, therapeutic paracentesis may be needed as well as other treatment methods.


Hepatic encephalopathy:

Hepatic encephalopathy, usually occurs in people with cirrhosis. It is reflected in impaired brain function, personality change, cognitive decline, and low level of awareness.


This disease is caused by the passage of blood to the brain directly without undergoing a process of purification in the liver. Normally the liver can convert the toxic substances produced by the body to non-toxic materials and disposed it. When the liver is infected, the toxic substances accumulate in the body and cause damage to various systems, In particular the brain

Symptoms of hepatic encephalopathy:

Hepatic encephalopathy is classified according to severity from 0-4 where the number 0 refers to the phase where no symptoms are present at all, and 4 to coma with no response to pain. Symptoms that may appear include:

  • The mouth breath smells like fruit
  • Changes in sleep pattern.
  • A tendency to forget things and lack of concentration
  • Changes in personality and mood.
  • Low level of judgment.
  • The deterioration of handwriting, or the difficulty of carrying out precise hand operations.
  • Abnormal movements resembling shiver in the hands (asterixis).
  • Disobedience and slow speech and incomprehensible.
  • In the final stage: deep coma

There are different cases that increase the possibility of encephalopathy as well as liver diseases:

  • Dehydration
  • Constipation
  • A meal containing a large amount of proteins.
  • Disorders in the concentration of various soluble substances, especially potassium, after vomiting or use of diuretics.
  • Bleeding in the digestive system.
  • Microbial infections
  • Deficiency in renal function.
  • Low oxygen level.
  • Medications affecting the central nervous system

Treatment of hepatic encephalopathy

Hepatic encephalopathy is an emergency requiring hospitalization. The first step is to treat the factor that caused the encephalopathy.

Prevention of hepatic encephalopathy

First of all, you should avoid the factors that cause illness, especially the use of drugs and drinking alcohol. In case of liver disease, it should be treated as soon as possible.

When there is severe liver damage, a low-protein diet is used to prevent an increase in the concentration of ammonia in the blood

Avoid constipation and dehydration.


Esophageal varices:

Is an expansion of the blood vessels in the lining membranes of the esophageal cavity that often appear in the lower part of the esophagus and are usually the result of portal hypertension.

The blood veins drains the blood from the abdominal organs to the liver. In the case of Cirrhosis Liver, there is an obstruction in the blood flow from the abdominal organs towards the liver. As a result, congestion occurs in the veins of the esophagus instead of blood flow from the spleen to the liver, blood passes through the veins of the esophagus to the superior vena cava. The more severe the disease in the liver, the greater the congestion of the esophagus veins.

The esophageal varices are usually silent and there are no noticeable symptoms, which may be discovered accidentally during the internal gastrointestinal endoscopy, but they may appear in the form of sudden pain in the stomach accompanied by bloody vomitus or black stool. It may progress rapidly and cause severe internal bleeding requiring rapid intervention to stop bleeding.

To reduce the risk of bleeding from esophageal varices, patients with cirrhosis and esophageal varices are treated with Propranolol. This medicine decrease the blood flow in the portal system. Its given to the appropriate patients as a preventive treatment.
Bleeding is treated by an endoscope, where a rubber ring is inserted. These treatments can lead to the disappearance of esophageal varices.