Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

For the approach to a patient with liver disease, please click here.

Normal Liver

Histopathological Findings of a Normal Liver

Viral hepatitis

Acute hepatitis A
Acute hepatitis B
Acute Hepatitis D
Acute hepatitis C
Acute hepatitis E
Chronic viral hepatitis
Other viral hepatitis viruses may exist but are not so firmly established as the previous ones: hepatitis G.

Histopathological Findings in Viral hepatitis

Histopathological Findings in Viral hepatitis with Fulminant Necrosis

Liver Dysfunction in other Infectious Diseases [1] [2]

Liver Dysfunction in other Infectious Diseases ^[1] ^[2]

Other Inflammatory Liver Diseases

Liver abscess
Autoimmune hepatitis
Primary biliary cirrhosis
Phlebitis of the portal vein
Granulomatous hepatitis
Hepatic granulomas in:
- Berylliosis
- Sarcoidosis

Alcoholic liver disease

This may cause fatty liver, hepatitis, fibrosis and sclerosis leading to cirrhosis and finally hepatic failure.

Histopathological Findings of Alcoholic Liver Disease

Toxic Liver Disease

This includes mostly drug-induced hepatotoxicity, which may generate many different patterns over liver disease, including;

Cholestasis
Necrosis
Acute hepatitis and chronic hepatitis of different forms,
Cirrhosis
Effects of Acetaminophen (Tylenol)
Other rare disorders like focal nodular hyperplasia, hepatic granulomas, peliosis hepatis and veno-occlusive disease.

Liver damage is part of Reye’s syndrome.

Histopathological Findings: Liver: Centrilobular Necrosis from Chloroform

Liver tumors

Malignant neoplasm of liver and intrahepatic bile ducts. The most frequent forms are metastatic malignant neoplasm of liver)

Liver cell carcinoma
- Hepatocellular carcinoma
- Hepatoma
Cholangiocarcinoma
Hepatoblastoma
Angiosarcoma of liver
Kupffer cell sarcoma
Other sarcomas of liver

Benign neoplasm of liver include hepatic hemangiomas, hepatic adenomas, and focal nodular hyperplasia (FNH).

End-stage liver disease

Chronic liver diseases like chronic hepatitis, chronic alcohol abuse or chronic toxic liver disease may cause

Hepatic failure and hepatorenal syndrome
Fibrosis and cirrhosis of liver

Cirrhosis may also occur in primary biliary cirrhosis. Rarely, cirrhosis is congenital.

Metabolic diseases (Chapter E in ICD-10)

Vascular Disorders

Chronic passive congestion of liver
Central haemorrhagic necrosis of liver
Infarction of liver
Peliosis hepatis
Veno-occlusive disease
Portal hypertension
Budd-Chiari syndrome

Cysts

Congenital cystic disease of liver
Cysts caused by Echinococcus

Others

Amyloid degeneration of liver

Gallbladder and biliary tract diseases

Malignant neoplasm of the gallbladder
Malignant neoplasm of other parts of biliary tract
- Extrahepatic bile duct
- Ampulla of Vater
Cholelithiasis
Cholecystitis
Others (excluding postcholecystectomy syndrome), but including
- Other obstructions of the gallbladder (like strictures
- Hydrops, perforation, fistula
- Cholesterolosis
- Biliary dyskinesia
K83: other diseases of the biliary tract:
- Cholangitis (including ascending cholangitis and primary sclerosing cholangitis)
- Obstruction, perforation, fistula of biliary tract
- Spasm of sphincter of Oddi
- Biliary cyst
- Biliary atresia

Diagnosis

In hepatology, important signs and symptoms include:

Complete Differential Diagnosis of Causes of Hepato-biliary diseases

Autoimmune, Systemic

Cholestatic

Infection

Liver Changes

Metabolic

Other

Treatment

Includes:

Motivate patient to stop drinking alcohol
Vaccination for hepatitis
Eradication of causative pathogens
Liver transplantion
Cholecystectomy

Active liver disease is considered an absolute contraindication to the use of the following medications:

Marked liver dysfunction is considered an absolute contraindication to the use of the following medications:

Liver dysfunction is considered an absolute contraindication to the use of the following medications:

Histopathological Findings in Liver Diseases

Liver: Cytomegalic inclusion disease

Liver: Alpha-1-antitrypsin deficiency

Liver: Cardiac sclerosis (cardiac cirrhosis)

Liver: Centrilobular necrosis from chloroform

Liver: Chronic active hepatitis, cirrhosis

Liver: Cirrhosis (micronodular)

Liver: Congenital cytomegalovirus disease

Liver: Erythroblastosis fetalis

Fulminant hepatitis (massive hepatic necrosis)

Liver: Hepatitis, yellow fever virus

Herpes hepatitis

Liver: Traumatic hemorrhage

Liver: Viral hepatitis with fulminant necrosis

Fulminant hepatitis (massive hepatic necrosis) is an acute liver failure (<1 month) resulting in rapid hepatic compensation characterized by synthetic dysfunction (hypoglycemia, coagulopathy), coma (cerebral edema, hepatic encephalopathy) and associated with infectious, renal, pulmonary and metabolic complications.