Hepatology is the branch of medicine that incorporates the study of liver, gallbladder, biliary tree, and pancreas as well as management of their disorders. Although traditionally considered a sub-specialty of gastroenterology, rapid expansion has led in some countries to doctors specializing solely on this area, who are called hepatologists.
Diseases and complications related to viral hepatitis and alcohol are the main reason for seeking specialist advice. More than two billion people have been infected with hepatitis B virus at some point in their life, and approximately 350 million have become persistent carriers. Up to 80% of liver cancers can be attributed to either hepatitis B or hepatitis C virus. In terms of mortality, the former is second only to smoking among known agents causing cancer. With more widespread implementation of vaccination and strict screening before blood transfusion, lower infection rates are expected in the future. In many countries, however, overall alcohol consumption is increasing, and consequently the number of people with cirrhosis and other related complications is commensurately increasing.
As for many medical specialties, patients are most likely to be referred by family physicians (i.e., GP) or by physicians from different disciplines. The reasons might be:
Drug overdose. Paracetamol overdose is common.
Gastrointestinal bleeding from portal hypertension related to liver damage
Abnormal blood test suggesting liver disease
Enzyme defects leading to bigger liver in children commonly named storage disease of liver
Jaundice / Hepatitis virus positivity in blood, perhaps discovered on screening blood tests
Ascites or swelling of abdomen from fluid accumulation, commonly due to liver disease but can be from other diseases like heart failure
All patients with advanced liver disease e.g. cirrhosis should be under specialist care
To undergo ERCP for diagnosing diseases of biliary tree or their management
Fever with other features suggestive of infection involving mentioned organs.
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Cirrhosis, also known as liver cirrhosis or hepatic cirrhosis, and end-stage liver disease, is the impaired liver function caused by the formation of scar tissue known as fibrosis due to damage caused by liver disease. Damage to the liver leads to repair of liver tissue and subsequent formation of scar tissue. Over time, scar tissue can replace normal functioning tissue, leading to the impaired liver function of cirrhosis. The disease typically develops slowly over months or years.
Liver cancer (also known as hepatic cancer, primary hepatic cancer, or primary hepatic malignancy) is cancer that starts in the liver. Liver cancer can be primary (starts in liver) or secondary (meaning cancer which has spread from elsewhere to the liver, known as liver metastasis). Liver metastasis is more common than that which starts in the liver. Liver cancer is increasing globally. Primary liver cancer is globally the sixth-most frequent cancer and the fourth-leading cause of death from cancer.
Liver disease, or hepatic disease, is any of many diseases of the liver. If long-lasting it is termed chronic liver disease. Although the diseases differ in detail, liver diseases often have features in common. File:Ground glass hepatocytes high mag cropped 2.jpg|Ground glass hepatocytes File:Primary biliary cirrhosis intermed mag much cropping.jpg|Primary biliary cirrhosis File:Buddchiari2.PNG|Budd-chiari syndrome File:Non-alcoholic_fatty_liver_disease1.
Background & Aims: Liver diseases are caused by many factors, such as genetics, nutrition, and viruses. Therefore, it is important to delineate transcriptomic changes that occur in various liver diseases. Methods: We performed high-throughput sequencing of ...
BACKGROUND: Ex vivo liver gene therapy provides an attractive alternative to orthotopic liver transplantation for the treatment of liver diseases. We previously reported a protocol in which human primary hepatocytes are highly transduced in Suspension with ...
Ex vivo gene therapy is an interesting alternative to orthotopic liver transplantation (OLT) for treating metabolic liver diseases. In this study, we investigated its efficacy and biosafety in nonhuman primates. Hepatocytes isolated from liver lobectomy we ...