By Sheila Sherlock, Dame.; James Dooley
content material: Anatomy and serve as --
overview of liver functionality --
Biopsy of the liver --
The haematology of liver ailment --
Ultrasound, tomography and magnetic resonance imaging --
Hepato-cellular failure --
Hepatic encephalopathy --
Acute liver failure --
The portal venous approach and portal high blood pressure --
The hepatic artery and hepatic veins: the liver in circulatory failure --
Cholestasis --Primary biliary cirrhosis --
Scherosing cholangitis --
Viral hepatitis: common beneficial properties, hepatitis A, hepatitis E and different viruses --
Hepatitis B virus and hepatitis delta virus --
Hepatitis C virus --
continual hepatitis: common beneficial properties, and autoimmune continual ailment --
medicines and the liver --
Hepatic cirrhosis --
Alcohol and the liver --
Iron overload states --
Wilson's ailment --
dietary and metabolic liver illnesses --
The liver in infancy and formative years --
The liver in being pregnant --
The liver in systemic ailment, granulomas and hepatic trauma --
The liver in infections --
Nodules and benign liver lesions --
Malignant liver tumours --
Imaging of the biliary tract: interventional radiology and endoscopy --
Cysts and congenital biliary abnormalities --
Gallstones and inflammatory gallbladder illnesses --
Benign stricture of the bile ducts --
ailments of the Ampulla of Vater and pancreas --
Tumours of the gallbladder and bile ducts --
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Extra info for Diseases of the liver and biliary system
This type of ‘shotgun’ investigation adds to the confusion. A few simple tests of established value should be used. If an abnormality is found it may need to be conﬁrmed by a repeat estimation to show that it is real and not a laboratory error. The tests most useful in the diagnostic work-up of jaundice (Chapter 12) are the serum alkaline phosphatase level and serum transaminase values. An isolated rise in serum unconjugated bilirubin suggests Gilbert’s syndrome or haemolysis. The severity of liver cell damage is assessed by serial measurement of serum total bilirubin, albumin, transaminase and prothrombin time after vitamin K.
An approximate value for the unconjugated (indirect) bilirubin is obtained by subtracting the value for conjugated bilirubin from that for the total bilirubin. These diazo reactions are subject to error and diagnosis should not be based solely upon them. Other more accurate methods for estimation, such as thin layer chromatography, high performance gas liquid chromatography and alkaline methanolysis, are available but are too elaborate to be clinically useful . Inspection of faeces is an important investigation in jaundice.
The continuing importance of bile acids in liver and intestinal disease. Arch. Intern. Med. 1999; 159: 2647. 6 Loria P, Carulli N, Medici G et al. Determinants of bile secretion: effect of bile salt structure on bile ﬂow and biliary cation secretion. Gastroenterology 1989; 96: 1142. 7 Shrestha R, McKinley C, Showalter R et al. Quantitative liver function tests deﬁne the functional severity of liver disease in early stage cirrhosis. Liver Transplant Surg. 1997; 3: 166. 8 Stiehl A, Raedsch R, Rudolph G.
Diseases of the liver and biliary system by Sheila Sherlock, Dame.; James Dooley