A Comprehensive Review on The Complications of Decompensated Liver Disease

Decompensated Chronic Liver Disease (DCLD) signifies the advanced stage of cirrhosis, characterized by the emergence of critical complications such as ascites, hepatic encephalopathy, variceal bleeding, and hepatorenal syndrome (HRS). This review aims to provide an in-depth overview of DCLD, including its epidemiology, underlying pathophysiology, diagnostic approaches, risk factors, and current management strategies. Cirrhosis results from persistent liver injury that leads to fibrosis and irreversible architectural damage. It is a global health concern, with increasing prevalence in developing countries like India, largely due to rising rates of alcohol use, obesity, and viral hepatitis. The transition from compensated to decompensated cirrhosis marks a significant decline in survival outcomes. The main causes include alcohol-related liver disease, viral hepatitis (B and C), NAFLD, and various autoimmune and genetic disorders. Diagnosis is based on clinical features, lab investigations, imaging studies, and prognostic scoring systems such as Child-Pugh and MELD. Management is multidisciplinary and includes interventions for complications such as portal hypertension, ascites, encephalopathy, and renal failure. Liver transplantation remains the definitive treatment. Early detection and targeted therapy can substantially improve clinical outcomes and reduce disease burden.