17 Obesity and its hepatic complications in adults and children
Key Points: Adults Obesity rates are increasing worldwide. Adults with a body mass index (BMI) of more than 30 (Caucasian) or more than 27 (Asian) are classified as obese and…
4 Natural history of the cirrhotic patient
Key Points Cirrhosis may be entirely asymptomatic with no clinical signs. Routine laboratory tests that may suggest underlying cirrhosis include: thrombocytopenia, hyperbilirubinemia, and hypoalbuminemia. Non-invasive tests (serum panels and transient…
6 Management of ascites
Key Points Ascites in a cirrhotic due to liver failure is a bad prognostic sign. MELD (see Chapters 2 and 4) should be calculated and liver transplantation should be considered….
7 Masses in the liver
Key Points Investigation of masses in the liver is largely radiological and biopsy is only necessary if radiological investigations fail to identify a cause with certainty. Hemangiomas are harmless and…
13 Chronic viral hepatitis in adults and children: hepatitis B
Key Points Country of birth is the most important risk factor for HBV infection. Age at acquisition is strongly associated with the risk of chronic infection (95% of infants develop…
16 Drug-induced liver disease
Key Points Virtually any drug can be a source of hepatotoxicity. Drugs are the commonest identified cause of fulminant hepatic failure in most Western centers. Recognition of the pattern of…
11 Management of the complications of liver transplantation
Key Points Early complications after liver transplantation include bleeding, bile leaks, anastomotic and non-anastomotic biliary strictures, and hepatic artery or portal vein thrombosis (seen most often in children). Acute cellular…
9 Indications for liver transplantation in adults and children
Key Points Patients should be considered for liver transplantation if they have evidence of fulminant hepatic failure, a life-threatening systemic complication of liver disease, or a liver-based metabolic defect. Organ…
10 Management of fulminant hepatic failure
Key Points The precise cause of fulminant hepatic failure is often unclear; drugs, especially acetaminophen, are the most common identified cause in many centers. Fulminant hepatic failure is a multisystem…
3 Pediatric liver disease: an approach to diagnosis and assessment of severity
Key Points The rapid growth of pediatric hepatology as a specific and focused field of interest is attributable to the importance of the dramatic physiologic variables occurring in the maturing…
