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Abstract Patients with cirrhosis are particularly susceptible to coagulation abnormalities. Such a vulnerability results from both long-standing morbidities and a high prevalence of hemodynamic, metabolic, and inflammatory factors that can determine occurrence of bleeding or thrombosis Incidence of venous thrombosis more common with advanced liver disease (Child-Pugh B and C), It may be explained by marked decreased hepatic synthesis of natural anticoagulant, and more prevalence of immobilization (e.g. sarcopenia, ascites, encephalopathy) or s associated with increased incidence of DVT or PE. Smoking also is a predictor for DVT and PE, while previous history of venous thromboembolism is associated with increased risk for portal vein thrombosis, and both DVT and PE.Sonoclot® analyzer- which assess whole coagulation process- reflects hypercoagulable state that manifest clinically in most of the patients, so it may be a helpful tool to assess coagulation abnormality in cirrhotic patients. but need further investigationAnticoagulant, unfractionated heparin, low molecular weight heparin or warfarin are safe to use in cirrhotic patients with special precaution (e.g..control of varices). |