Liver Cirrhosis & Pancreatitis: Causes, Complications & Key Differences

Cirrhosis (liver scarring) and pancreatitis (pancreas inflammation) are distinct conditions, though alcohol causes both.

Cirrhosis

Causes

• Alcohol-associated liver disease
• Chronic hepatitis B/C
• NAFLD/NASH (metabolic syndrome)
• Autoimmune hepatitis, PBC, PSC
• Genetic: hemochromatosis, Wilson, α1-antitrypsin deficiency

Complications

• Portal hypertension → varices, ascites, splenomegaly
• Hepatic encephalopathy
• Jaundice, coagulopathy, hypoalbuminemia
• Hepatorenal syndrome, hepatopulmonary syndrome
• HCC (hepatocellular carcinoma) — surveillance q6mo

Pancreatitis

Causes

• Gallstones (biliary) — #1
• Alcohol — #2
• Hypertriglyceridemia (>1000 mg/dL)
• Drugs (azathioprine, valproate, GLP-1s, etc.)
• ERCP, trauma, genetic (PRSS1, SPINK1, CFTR), autoimmune

Complications

• Necrotizing pancreatitis → infected necrosis, sepsis
• Pseudocyst, walled-off necrosis
• Pancreatic fistula
• Exocrine insufficiency (malabsorption)
• Endocrine insufficiency → diabetes (type 3c)

Overlap

• Alcohol → both.
• Gallstone pancreatitis can cause biliary cirrhosis if chronic obstruction.
• Autoimmune: IgG4-related disease affects both.

Diagnosis: imaging (US, CT, MRI/MRCP), labs (LFTs, lipase, IgG4, autoantibodies), sometimes biopsy. Management is organ-specific but requires shared etiology addressing (alcohol cessation, metabolic control).