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Hepatology is the branch of medicine that is concerned with disorders of the liver, gall bladder and bile ducts. Although occasionally practiced by specialised hepatologists, it is most often considered the terrain of gastroenterology.
The most important diseases that hepatology studies are hepatitis, alcoholic liver disease, toxic liver disease and hepatic tumours. Many chronic liver diseases finally end up at a stage called cirrhosis, another import field in hepatology. Hepatologists are also involved in (indications for and follow-up of) | liver transplantions .
=Liver diseases=
Viral hepatitis
- Acute hepatitis A
- Acute hepatitis B
- Acute Hepatitis D -this is actually a superinfection with the delta-agent in a patient already infected with hepatitis B
- Acute hepatitis C
- Acute hepatitis E
- Chronic viral hepatitis
- Other viral hepatitis virusses may exist but are not so firmly established as the previous ones: hepatitis G.
Other disorders in infectious diseases
- Hepatitis:
- cytomegalovirus
- herpesviral: herpes simplex
- toxoplasma
- Hepatosplenic schistosomiasis
- Portal hypertension in schistosomiasis
- Liver disease in syphilis
- Epstein-Barr virus
- yellow fever virus
- rubella virus
- leptospirosis
- Echinococcus
- Amoebiasis
Other inflammatory liver diseases
- liver abcess
- autoimmune hepatitis
- phlebitis of the portal vein
- granulomatous hepatitis
- Hepatic granulomas in:
Alcoholic liver disease
This may cause fatty liver, hepatitis, fibrosis and sclerosis leading to cirrhosis and finally hepatic failure.
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
- other rare disorders like focal nodular hyperplasia, hepatic granulomas, peliosis hepatis and veno-occlusive disease.
Liver tumours
Malignant neoplasm of liver and intrahepatic bile ducts. The most frequent forms are metastatic malignant neoplasm of liver)
- liver cell carcinoma
- 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
Metabolic diseases
- metabolic diseases (chapter E in ICD-10)
Vascular disorders
- chronic passive congestion of liver
- central haemorrhagic necrosis of liver
- infarction of liver
- perliosis 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 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:
- history of alcohol abuse
- liver function tests
- hepatomegaly
- hypoalbuminemia and ascites
- jaundice or icterus
- Murphy's sign
- liver biopsy
=Treatment= Includes:
- motivate patient to stop drinking alcohol
- vaccination for hepatitis
- eradication of causative pathogens
- | liver transplantion
- cholecystectomia
=Scientific research=
Journals
- The American Journal of Physiology - Gastrointestinal and Liver Physiology
- Archives of Gastroenterohepatology
- Comparative Hepatology
- Current Hepatitis Reports
- European Journal of Gastroenterology and Hepatology
- Gastroenterología y Hepatología
- Gastroenterology (journal of the American Gastroenterological Association)
- Hepatology (journal of the American Association for the Study of Liver Diseases)
- HPB
- Journal of Gastroenterology and Hepatology
- Journal of Hepato-Biliary-Pancreatic Surgery
- Journal of Hepatology (journal of the European Association for the Study of Liver Diseases)
- Journal of Viral Hepatitis
- Liver
- Liver Transplantation (from the American Association for the Study of Liver Diseases)
- Nature clinical practice. Gastroenterology & hepatology.
Societies
- American Association for the Study of Liver Diseases
- American College of Gastroenterology
- American Gastroenterological Association
- American Hepato-Pancreato-Biliary Association
- American Liver Society
- Austrian Society of Gastroenterology and Hepatology
- British Society of Paediatric Gastroenterology, Hepatology and Nutrition
- Canadian Association for the Study of the Liver
- Czech Society of Hepatology
- Danish Association for the Study of the Liver
- European Association for the Study of the Liver
- European Society of Paediatric Gastroenterology, Hepatology and Nutrition
- French Association for the Study of the Liver
- International Hepato-Pancreato-Biliary Association
- International Liver Transplantation Society
- Israel Association for the Study of the Liver
- North American Society for Pediatric Gastroenterology, Hepatology and Nutrition
- Society for Surgery of the Alimentary Tract
- Spanish Society of Pediatric Gastroenterology, Hepatology and Nutrition
- Swiss Association for the Study of the Liver
- Turkish Association for the Study of the Liver
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"Hepatology"