Hepatitis virus B will be used as a model here. After an incubation period, acute viral hepatitis most often begins with some combination of GI tract symptoms, fever, chills, and malaise, lasting 4-7 days. During this phase there is no clinical jaundice. Leukopenia with a relative lymphocytosis is common, and there may be a few […]
This procedure has been greatly simplified, and its morbidity and mortality markedly reduced, by the introduction of small-caliber biopsy needles such as the Menghini. Nevertheless, there is a small but definite risk. Relative contraindications to biopsy include a PT in the anticoagulant range or a platelet count less than 50,000/mm3. Liver biopsy is especially useful […]
Endoscopic retrograde choledochopancreatography entails passing a special endoscopic tube system into the duodenum, entering the pancreatic duct or the common bile duct with the end of a cannula, and injecting x-ray contrast material. The procedure is used predominantly for diagnosis of pancreatic disease, but it may occasionally be helpful in equivocal cases of biliary tract […]
Percutaneous transhepatic cholangiography consists of inserting a cannula into one of the intrahepatic bile ducts through a long biopsy needle and injecting x-ray contrast material directly into the duct. This procedure outlines the biliary duct system and both confirms biliary tract obstruction by demonstrating a dilated duct system and pinpoints the location of the obstruction. […]
Ultrasound has been reported to detect metastatic liver tumor in approximately 85%-90% of patients (literature range, 63%-96%, with some of the lower figures being earlier ones). Computerized tomography (CT) has a sensitivity of 90%-95%. Radionuclide scans detect a few more patients with diffuse liver abnormality than CT or ultrasound. However, CT and ultrasound can differentiate […]
If a radioactive colloidal preparation is injected intravenously, it is picked up by the reticuloendothelial system. The Kupffer cells of the liver take up most of the radioactive material in normal circumstances, with a small amount being deposited in the spleen and bone marrow. If a sensitive radioactive counting device is placed over the liver, […]
Fetal liver produces an alpha-1 globulin called “alpha fetoprotein” (AFP), which becomes the dominant fetal serum protein in the first trimester, reaching a peak at 12 weeks, then declining to 1% of the peak at birth. By age 1 year, a much greater decrease has occurred. Primary liver cell carcinomas (hepatomas) were found to produce […]
Antibodies that react against specific structures in cells can be demonstrated by immunofluorescent technique. Antimitochondrial antibodies are found in 80%-100% of biliary cirrhosis patients and may aid in the diagnosis of this uncommon disease. False positive results have been reported in some patients with drug-induced cholestasis and chronic active hepatitis, as well as in a […]
One function of the liver is the synthesis of urea from various sources of ammonia, most of which come from protein-splitting bacteria in the GI tract. In cirrhosis, there is extensive liver cell destruction and fibrous tissue replacement of areas between nodules of irregularly regenerating liver cells. This architectural distortion also distorts the hepatic venous […]
Serum albumin levels decrease to variable degrees in many severe acute and chronic disorders. Albumin is synthesized in the liver, so most acute or chronic destructive liver diseases of at least moderate severity also result in decreased serum albumin levels. In addition, there may be other serum protein changes. In cirrhosis of moderate to severe […]
