[Importance of environmental factors for the development of liver cirrhosis]

The frequency of cirrhoses drastically increased in the seventies. This increase was predominantly due to an augmentation of alcoholic cirrhosis in men. Cirrhosis is significantly more wide-spread in men than in women. Most of the cirrhoses in women are of unknown origin. Morphologically, the alcoholic cirrhoses are of the micronodular types in their great majority. Combined with HBsAg positivity, the macronodular type is most frequent. The classification in micro- and macronodular cirrhoses do not imply a different etiology but it may indicate different stages in cirrhosis of identic origin. Histologically, the signs of alcoholic hepatitis particularly help to trace back the alcoholic etiology. If HBsAg can be detected and the margins of the pseudolobules are moth- eatenlike , this speaks for a hepatitic origin. The lowest average age was observed in cases of alcoholic cirrhoses, the highest in HBsAg positive cirrhoses of women. Men suffering from cirrhosis die earlier than women. In the case of alcoholic origin, the bulk of the cirrhotic livers are eutrophic while, beside HBsAg positivity, the atrophic livers are prevailing. The two most frequent environmental causes of cirrhosis are alcoholic beverages and hepatitis. Better exploration of the environmental factors and clearing up the origin of cryptogenic cirrhoses are essential tasks of the future.