Variceal hemorrhage, hepatic encephalopathy, and ascites—the major complications of cirrhosis of the liver (see Chapters 74, 93, and 94 )—result from portal hypertension, defined as an increase in hepatic sinusoidal pressure to 6 mm Hg or greater. Portosystemic collaterals decompress…
Acknowledgments The authors thank Jayant A. Talwalkar and the late Paul Angulo for their contributions to this chapter. PBC is an autoimmune liver disease that generally affects middle-aged women and is the most common chronic cholestatic liver disease in adults…
Autoimmune hepatitis (AIH) is a disease of unknown cause that is characterized by the presence of autoantibodies, hypergammaglobulinemia, and histologic features of interface hepatitis ( Fig. 90.1 ) and lymphoplasmacytic infiltration ( Fig. 90.2 ). Diagnosis requires the exclusion of…
Contemporary inhalation and parenterally administered anesthetics are rarely hepatotoxic. Although halothane hepatitis is now largely of historical interest in Western nations, it remains in use elsewhere, with ongoing reports of acute liver injury. , In contrast to the largely unpredictable…
Hepatic Drug Metabolism Role of the Liver in Drug Elimination By virtue of the portal circulation, the liver is highly exposed to drugs and other toxins absorbed from the intestine. Most drugs tend to be lipophilic compounds that are readily…
The global obesity epidemic has dramatically increased the prevalence of NAFLD and made it the leading cause of chronic liver disease in Western nations. NAFLD is considered the hepatic manifestation of the metabolic syndrome and shares a strong association with…
Alcohol-associated liver disease (ALD) remains a challenging enigma for basic scientists and clinicians. Despite extensive research and clinical trials since the 1940s, many important facets of this disease have yet to be resolved. Paramount among these important questions are the…
Vascular disorders of the liver are characterized by a primary alteration in blood or lymphatic vessels, excluding the vascular changes secondary to parenchymal or biliary diseases. Primary alterations consist of obstruction, fistula, aneurysm, or absence (due to agenesis or disappearance)…
The liver serves as the initial site of filtration of absorbed intestinal luminal contents and is particularly susceptible to contact with microbial antigens of all varieties. In addition to infection by viruses (see Chapter 78, Chapter 79, Chapter 80, Chapter…
In addition to hepatitis A to E, a number of other viruses have been shown to be hepatotropic in that viremia is occasionally associated with elevations in serum aminotransferase levels and viral replication may occur in hepatocytes; however, causality with…