Cirrhosis : a practical guide to management

Content: Cirrhosis: A Practical Guide to Management
 Contents
 List of contributors
 Foreword
 List of abbreviations
 Part 1: Diagnosis and pathophysiology
 1. Clinical clues to the diagnosis of cirrhosis
 Introduction
 Clinical presentation
 Patient history
 Abdominal distension (ascites)
 Jaundice
 Upper gastrointestinal bleeding
 Hepatic encephalopathy
 Etiologic history taking
 Alcohol intake: how much is significant
 History of other risk factors
 Examination
 General examination
 Nutritional status
 Cutaneous clues
 Spider angioma
 Palmar erythema
 Dupuytren's contracture
 Leukonychia. Muehrcke's nailsBier spots
 Paper-money skin
 Hypogonadism and gynecomastia
 Parotidomegaly
 Other manifestations
 Abdominal examination
 Abdominal veins
 Cruveilhier-Baumgarten murmur
 Examination of the liver
 Examination of the spleen
 Examination for ascites
 Neurologic examination
 References
 2. Diagnostic laboratory tests
 Introduction
 Tests that detects hepatic injury (Table 2.1)
 Serum aminotransferases
 Serum biliary enzymes
 Tests of hepatic metabolism (Table 2.1)
 Serum bilirubin
 Serum ammonia
 Indocyanine green and bromsulphalein tests. Tests of hepatic biosynthetic function (Table 2.2)Serum albumin
 Prothrombin time and international normalized ratio
 Individual serum coagulating factor levels
 Factor VIII
 Factors V and VII
 Cell counts and other biochemistry (Table 2.2)
 Thrombocytopenia
 Neutropenia
 Anemia
 Globulins
 Hyponatremia
 Accuracy of routine laboratory investigations (Table 2.3)
 Combination indices or models for detecting cirrhosis (Table 2.4)
 Specific tests for determining the etiology of liver cirrhosis
 Tests for viral hepatitis
 Tests for alcoholic liver disease
 Tests for primary biliary cirrhosis. Tests for primary sclerosing cholangitisTests for hereditary hemochromatosis
 Transferrin saturation
 Plasma ferritin level
 Tests for Wilson's disease
 Serum ceruloplasmin
 Serum copper
 Urine copper excretion
 Tests for alpha-1 antitrypsin deficiency
 Conclusions
 References
 3. Diagnostic imaging modalities
 Ultrasonography-based approaches
 Grayscale and Doppler US
 Contrast-enhanced ultrasonography
 Measurement of liver stiffness: transient elastography, acoustic radiation force impulse, supersonic shear-wave elastography, and real-time elastography
 CT- and MRI-based approaches. Morphologic changesHemodynamic changes
 MR elastography
 Other imaging techniques
 References
 4. Histology/pathology
 Introduction
 Cirrhosis: a pathologic spectrum
 Fibrosis: extracellular accumulation of matrix components
 Vascular changes
 Parenchymal nodules: etiologic features
 Cirrhosis: an evolving concept
 Cirrhosis: a preneoplastic condition
 Cirrhosis: a place for biopsy?
 References
 5. Fibrosis and fibrogenesis
 Introduction
 Mechanism of liver fibrosis in hepatitis B and C
 Diagnosis of liver fibrosis by imaging
 Diagnosis of liver fibrosis by laboratory tests.