Cirrhosis of the liver

General information

Cirrhosis of the liver is sometimes referred to as hepatic cirrhosis. It is characterised by diffuse interlacing bands of fibrous tissue typically dividing the hepatic parenchyma into micronodular or macronodular areas.

Signs and symptoms

There may be no clinical signs as onset is often insidious. A firm, nodular liver may be an early sign of disease; the liver may be either enlarged, normal, or decreased in size. Non-specific symptoms may include fatigue and weakness. Eventually the clinical manifestations of hepatocellular dysfunction and portal hypertension ensue, including progressive jaundice, bleeding from gastroesophageal varices, ascites, and encephalopathy. The abrupt onset of one of these complications may be the first event prompting the patient to seek medical attention. However, routine tests of liver function may be quite normal in cirrhosis. The diagnosis may be based on clinical features together with laboratory findings and can be confirmed by liver biopsy.

Establishing onset

The condition may well have been present for some time before it was noted as it can be symptomless and the veteran or member may not have sought medical attention. Once identified a veteran or member would have needed significant medical attention at that time. It would be expected that such medical treatment would be recorded in doctors' notes and/or hospital records. However, if these records cannot be obtained, a reliable history of cirrhosis of the liver at a particular time will generally be accepted, unless there is contradictory evidence. Obtain medical advice if it is unclear whether the claimed symptoms and treatment at that time can be attributed to cirrhosis of the liver rather than to some other condition.

Last reviewed for CCPS 12 March 2008.

Preliminary questions [33822]

7784     there is some evidence that cirrhosis of the liver may be a factor in the development or worsening of the condition under consideration.

10548 the veteran has non-insulin dependent diabetes mellitus (type 2).

22586 the veteran has had cirrhosis of the liver at some time.

33823  the veteran has established the causal connection between the cirrhosis of the liver and VEA service for diabetes mellitus.

33825 the veteran had cirrhosis of the liver at the time of the clinical onset of the condition under consideration.

33824   the veteran has established the causal connection between the cirrhosis of the liver and VEA service for the clinical onset of diabetes mellitus.

33828  the veteran has established the causal connection between the cirrhosis of the liver and operational service for the clinical onset of diabetes mellitus.

or

33829  the veteran has established the causal connection between the cirrhosis of the liver and eligible service for the clinical onset of diabetes mellitus.

or

7334     the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

7335     the condition under consideration permanently worsened.

33826 the veteran had cirrhosis of the liver at the time of the clinical worsening of the condition under consideration.

33827   the veteran has established the causal connection between the cirrhosis of the liver and VEA service for the clinical worsening of diabetes mellitus.

33831  the veteran has established the causal connection between the cirrhosis of the liver and operational service for the clinical worsening of diabetes mellitus.

or

33830  the veteran has established the causal connection between the cirrhosis of the liver and eligible service for the clinical worsening of diabetes mellitus.

Clinical onset and operational service [33828]

22588  the cirrhosis of the liver is causally related to operational service.

Clinical onset and eligible service [33829]

22589  the cirrhosis of the liver is causally related to eligible service.

Clinical worsening and operational service [33831]

22588  the cirrhosis of the liver is causally related to operational service.

30507 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the cirrhosis of the liver is causally related.

Clinical worsening and eligible service [33830]

22589  the cirrhosis of the liver is causally related to eligible service.

30508 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the cirrhosis of the liver is causally related.