Metabolic liver diseases may manifest as acute, life-threatening illnesses in the neonatal period or as chronic liver disease in adolescence or adulthood, with progression to liver failure, cirrhosis, or HCC. In a 2015 report of the Scientific Registry of Transplant…
Copper, a component of numerous essential enzymes, is toxic to cells when present in excess. Dietary intake of copper generally exceeds the trace amount required physiologically, and mechanisms to control influx and efflux from cells must maintain an appropriate balance.…
Trousseau was the first to describe a case of hemochromatosis in the French pathology literature in 1865. Almost 25 years later, in 1889, von Recklinghausen, thinking that the disease was a blood disorder that caused increased skin pigmentation, introduced the…
Cirrhosis, a final pathway for a wide variety of chronic liver diseases ( Box 74.1 ), is a pathologic entity defined as diffuse hepatic fibrosis with the replacement of the normal liver architecture by nodules. The rate of progression of…
When appropriately ordered and interpreted, serum liver biochemical tests, the so-called “liver function tests” or “liver chemistries,” can be useful in the evaluation and management of patients with liver disorders. The term liver biochemical tests is preferable to liver function…
Hepatic parenchymal cells (hepatocytes and cholangiocytes) and nonparenchymal cells (hepatic sinusoidal endothelial cells, stellate cells, Kupffer cells, and pit cells) have distinct functions that are integrated through extensive cross-talk. These cells are highly polarized. The distinctive polarization pattern of hepatocytes…
Embryology The liver develops at 3 to 4 weeks’ gestation as an outgrowing diverticulum of proliferating endodermal cells from the ventral wall of the foregut in response to signals from the adjacent developing heart ( Fig. 71.1 ). In the…
Endoscopic therapy and radiologic treatment of biliary disease have evolved in separate but parallel manners. Endoscopic therapy is performed using ERCP and EUS-guided techniques. ERCP is performed primarily by endoscopists trained in a gastroenterology fellowship program, but in some centers…
Acknowledgment This work was supported by grants from the NIH DK59427 (G.J.G.) and K08CA236874 (S.H.R.). Support was also provided to Dr. Rizvi by a Pilot & Feasibility Award by the Center for Cell Signaling in Gastroenterology (P30DK084567), and an AGA…
Acknowledgments The authors acknowledge the contributions of Drs. Andrew S. Ross and Kris V. Kowdley to this chapter in previous editions of the book. Sclerosing cholangitis encompasses a spectrum of cholestatic conditions that are characterized by patchy inflammation, fibrosis, and…