Key Points 1 Primary bacterial infection of the liver is rare. Systemic infections can cause hepatic derangements, ranging from mild liver biochemical test abnormalities to frank jaundice and, rarely, hepatic failure. 2 Many different spirochetal, protozoal, helminthic, and fungal organisms…
Key Points 1 Hepatic abscesses are most commonly pyogenic in Western countries, but amebic abscesses are common in areas of the world where Entamoeba histolytica is endemic. Less frequent causes include fungal and tuberculous abscesses. 2 Diagnosis of hepatic abscess…
Key Points 1 Hemangioma of the liver is found in up to 20% of the normal population and is rarely of clinical consequence. 2 Other benign tumors of the liver are rare, including hepatic adenoma, which usually requires surgical resection…
Key Points 1 Granulomas consist of activated macrophages (epithelioid macrophages) accompanied by T lymphocytes and other immune cells, which infiltrate liver tissue as nodular lesions in reaction to indigestible or foreign antigen or are due to triggering of an untoward…
Key Points 1 Approximately 10% of human immunodeficiency virus (HIV)–infected persons worldwide are chronically infected with hepatitis B virus. The choice of antiviral therapy depends on the need for HIV treatment. 2 Approximately 30% of HIV-infected persons are chronically coinfected…
Key Points 1 The clinical presentation, prognosis, and management of several liver disorders can be different in older adults than in younger persons. 2 Hepatic blood flow, liver size, and hepatic regenerative capacity decrease with age; these changes result in…
Key Points 1 The liver is physiologically immature during the perinatal period, and significant maturational changes in hepatic metabolic processes occur in early life. These metabolic processes affect the presentation of and reaction to viral and toxin exposures. 2 Inherited…
Key Points 1 Abnormal liver biochemical test levels are associated with many different systemic diseases. These abnormalities are generally incidental, but in some systemic diseases the liver may be severely compromised ( Table 24.1 ). TABLE 24.1 The Liver in…
Key Points 1 Liver diseases in pregnancy include those that occur exclusively in pregnancy and those that occur coincidentally in pregnancy or are present at the time of pregnancy. 2 Normal physiologic changes in pregnancy may alter the normal range…
Key Points 1 Liver involvement (cardiac hepatopathy) in either forward or backward heart failure is frequent, the extent of which depends on the severity of the heart failure. 2 Backward heart failure causes congestion of the liver with hepatomegaly with…