Alcoholic hepatitis most commonly occurs in patients who are already cirrhotic, and has a very reliable pattern of basic counts and chemistries. The mainstays of management include the decision to use pharmaceuticals and the preferred route of nutrition. Advertisements
Primary sclerosing cholangitis is an autoimmune condition often associated with ulcerative colitis, affecting the medium and large caliber bile ducts in men (moreso than women). Periductular inflammation and fibrosis produce strictures that lead to bile stasis, cholangitis and liver failure.
Occasionally, the hepatologist is consulted for markedly elevated transaminase levels…that turn out to be secondary to a non-liver pathology. In this case, a middle aged female was admitted to the liver service with AST > 1000 and ALT > … Continue reading
Hepatocellular carcinoma (HCC) is the most common primary liver malignancy, and occurs in the setting of cirrhosis in 80% of cases. With appropriate screening methods, including ultrasound and alpha fetoprotein (AFP) measurements at six-month intervals for patients with cirrhosis, many … Continue reading
The comedy, too, of life will be spread before you, and nobody laughs more often than the doctor at the pranks Puck plays upon the Titanias and the Bottoms [referring to Shakespeare’s (1564-1616) A Midsummer Night’s Dream] among his patients. … Continue reading
A 51 year old male without known medical history presents to the emergency room with upper GI bleeding. Emergent endoscopy reveals isolated gastric varices, which are injected with sclerosant successfully. Gastric varices often occur in the setting of cirrhosis and portal … Continue reading
Liver fibrosis is the wound healing pathway of chronic liver disease. It is a dynamic process of scar tissue deposition and removal. However, with ongoing insult to the liver the result is often stage IV liver fibrosis, or cirrhosis. … Continue reading