Once a fatty liver patient has a large spleen is it a sign of cirrhosis? We all know that fatty liver is caused by the accumulation of excessive fat within the liver cells, resulting in abnormal liver fat metabolism and causing elevated liver function transaminases and bilirubin indicators. The liver damage caused by mild fatty liver often does not cause the spleen to become congested and enlarged, nor does it lead to the formation of cirrhosis. Of course, if a patient with fatty liver is originally combined with hepatitis B, then hepatitis B will cause cirrhosis and the formation of a congested and enlarged spleen. The liver damage caused by moderate and severe fatty liver is often difficult to recover completely within a short period of time, and if the patient does not receive timely medication it is likely that the progressive liver damage will increase, eventually leading to a large proliferation of liver cells and fibrous tissue, making the liver hard. The portal blood return is blocked, resulting in increased portal vein pressure and a congested and enlarged spleen. At this point, cirrhosis caused by fatty liver will have common manifestations of cirrhosis such as esophagogastric varices leading to gastrointestinal bleeding and hypoproteinemia leading to fluid accumulation in the abdominal cavity. This shows that severe fatty liver may indeed cause cirrhosis of the liver, resulting in congestion and enlargement of the spleen, but as long as patients have a strong sense of liver care and treatment, early prevention and active treatment, most mild fatty liver can slowly return to normal.