By Sheila Sherlock, Dame.; James Dooley
content material: Anatomy and serve as --
evaluation of liver functionality --
Biopsy of the liver --
The haematology of liver illness --
Ultrasound, tomography and magnetic resonance imaging --
Hepato-cellular failure --
Hepatic encephalopathy --
Acute liver failure --
The portal venous process and portal high blood pressure --
The hepatic artery and hepatic veins: the liver in circulatory failure --
Cholestasis --Primary biliary cirrhosis --
Scherosing cholangitis --
Viral hepatitis: normal gains, hepatitis A, hepatitis E and different viruses --
Hepatitis B virus and hepatitis delta virus --
Hepatitis C virus --
continual hepatitis: basic gains, and autoimmune persistent illness --
medicinal drugs and the liver --
Hepatic cirrhosis --
Alcohol and the liver --
Iron overload states --
Wilson's disorder --
dietary and metabolic liver ailments --
The liver in infancy and formative years --
The liver in being pregnant --
The liver in systemic sickness, 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 ailments --
Benign stricture of the bile ducts --
illnesses 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
Arch. Pathol. Lab. Med. 1989; 113: 73. 2 Fevery J, Blanckaert N. What can we learn from analysis of the serum bilirubin? J. Hepatol. 1986; 2: 113. 3 Mandema E, DeFraiture WH, Nieweg HO et al. Familial chronic idiopathic jaundice (Dubin–Sprinz disease) with a note on bromsulphalein metabolism in this disease. Am. J. Med. 1960; 28: 42. Serum enzyme tests These tests will usually indicate the type of liver injury, whether hepato-cellular or cholestatic, but cannot be expected to differentiate one form of hepatitis from another or to determine whether cholestasis is intra- or extra-hepatic.
Results in cirrhotic rats suggest that reduced N-demethylation is due to loss of liver cell volume. The function per hepatocyte remains constant. It is of value in prognosis  and to assess therapy rather than for screening or diagnosis. It may be useful to assess the effect of drugs on hepatic microsomal enzyme function. The 13C-methacetin breath test discriminates well between cirrhotic and non-cirrhotic patients but its prognostic value has not been established . 14 C-caffeine and phenacetin have been used as breath test substances.
5–2 times normal are sometimes seen in acute cholestasis, very high values are found in chronic conditions, especially post-operative stricture and primary biliary cirrhosis. Values of over ﬁve times the upper limit of normal are associated with skin xanthomas. Malnutrition lowers the serum cholesterol so that values may be normal in carcinomatous biliary obstruction. The level of cholesterol ester is decreased due to LCAT deﬁciency. Triglycerides tend to be increased. An abnormal lipoprotein, lipoprotein X, very rich in free cholesterol and lecithin is found which appears on electron microscopy as bilamellar discs.