BOOK
Sleisenger and Fordtran's Gastrointestinal and Liver Disease E-Book
Mark Feldman | Lawrence S. Friedman | Lawrence J. Brandt
(2015)
Additional Information
Book Details
Abstract
- Consult this title on your favorite e-reader .
- Get the essential gastroenterology information you need from one authoritative source with an outstanding global reputation for excellence.
- Zero in on the key information you need to know with a consistent, full-color chapter design.
- Stay up to date with emerging and challenging topics: enteric microbiota and probiotics; fecal microbiota transplantation; Clostridium difficile colitis; and factitious gastrointestinal diseases.
- Incorporate the latest findings and improvements in care for liver disease patients—from diagnosis and treatment through post-treatment strategies and management of complications.
- Expert Consult eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, references, and videos from the book on a variety of devices.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Vol-1 | Vol-1-Cover | ||
| Front cover | Vol-1-Cover | ||
| IFC_Vol.1 | IBC2 | ||
| Sleisenger and Fordtran’s Gastrointestinal and Liver Disease | Vol-1-iii | ||
| Copyright page | Vol-1-iv | ||
| Dedication | Vol-1-v | ||
| Contributors | Vol-1-vii | ||
| Foreword | Vol-1-xix | ||
| Preface | Vol-1-xxi | ||
| Table of Contents | Vol-1-xxiii | ||
| Video Contents | Vol-1-xxix | ||
| Abbreviation List | Vol-1-xxxi | ||
| I Biology of the Gastrointestinal Tract | 1 | ||
| 1 Cellular Growth and Neoplasia | 3 | ||
| Chapter Outline | 3 | ||
| Mechanisms of Normal Cell Homeostasis | 3 | ||
| Cellular Proliferation | 3 | ||
| Apoptosis | 4 | ||
| Senescence | 4 | ||
| Signaling Pathways That Regulate Cellular Growth | 4 | ||
| Intestinal Tumor Development | 6 | ||
| Multistep Formation | 6 | ||
| Clonal Expansion | 8 | ||
| Cancer Stem Cells | 8 | ||
| Neoplasia-Associated Genes | 8 | ||
| Oncogenes | 8 | ||
| Peptide Growth Factor Oncogenes | 8 | ||
| Protein Kinase–Related Oncogenes | 8 | ||
| Signal Transduction–Related Oncogenes (Membrane-Associated G Proteins) | 8 | ||
| Nuclear Oncogenes | 9 | ||
| Tumor Suppressor Genes | 9 | ||
| Tumor Suppressor Gene Inactivation | 10 | ||
| Adenomatous Polyposis Coli Gene | 10 | ||
| TP53 Gene | 10 | ||
| SMAD4 Gene | 10 | ||
| DNA Repair Genes | 10 | ||
| Oncogenic Signaling Pathways | 11 | ||
| Noncoding RNAs | 11 | ||
| Epigenetics | 12 | ||
| Tumor Metabolism | 12 | ||
| Environmental and Microenvironmental Influences | 12 | ||
| Chemical Carcinogenesis | 12 | ||
| Dietary Factors | 12 | ||
| Microbiome | 13 | ||
| Inflammation and Cancer | 13 | ||
| Biological Features of Tumor Metastasis | 13 | ||
| Epithelial-Mesenchymal Transition | 13 | ||
| Angiogenesis and Lymphangiogenesis | 14 | ||
| Molecular Medicine: Current and Future Approaches in Gastrointestinal Oncology | 14 | ||
| Molecular Diagnostics | 14 | ||
| Genome-wide Association Studies | 14 | ||
| Whole Genome Sequencing and Exome Sequencing | 15 | ||
| Key References | 15 | ||
| References | 15.e1 | ||
| 2 Mucosal Immunology and Inflammation* | 16 | ||
| Chapter Outline | 16 | ||
| Immune Responses in Gut-Associated Lymphoid Tissue | 16 | ||
| Controlled/Physiologic Inflammation | 16 | ||
| Oral Tolerance | 17 | ||
| Unusual Immunoglobulins of Gut-Associated Lymphoid Tissue | 18 | ||
| Physiology of Gut-Associated Lymphoid Tissue and the Intestinal Barrier | 20 | ||
| Functional Anatomy of Gut-Associated Lymphoid Tissue | 20 | ||
| Peyer’s Patches and M Cells | 20 | ||
| Intestinal Epithelial Cells | 21 | ||
| Antigen Trafficking Across the Epithelium | 21 | ||
| Recognition of Pathogen-Associated Molecular Patterns by Pattern Recognition Receptors | 21 | ||
| Antigen Presentation in the Gut | 22 | ||
| Intestinal Mononuclear Cells | 22 | ||
| Intraepithelial Lymphocytes | 22 | ||
| Lamina Propria Mononuclear Cells | 24 | ||
| T Cell Differentiation | 24 | ||
| Innate Lymphoid Cells | 25 | ||
| Dendritic Cells | 25 | ||
| Gut-Associated Lymphoid Tissue–Relevant Chemokines | 25 | ||
| Key References | 26 | ||
| References | 27.e1 | ||
| 3 The Enteric Microbiota | 28 | ||
| Chapter Outline | 28 | ||
| Life without Microbes | 28 | ||
| Primer on Terminology | 28 | ||
| Methodologies Used to Study the Microbiota | 29 | ||
| Next-Generation Sequencing | 29 | ||
| HITChip | 30 | ||
| Metagenomics | 30 | ||
| Characteristics of the Human Gastrointestinal Microbiota | 30 | ||
| Host-Microbe Spatial Relationships | 30 | ||
| Host-Microbe Age-Sensitive Relationships | 31 | ||
| Microbe-Microbe Signaling | 31 | ||
| Language of Host-Microbe Dialogue | 32 | ||
| Microbes, Immunity, and Metabolic Health | 33 | ||
| Microbiota Composition and Disease Associations | 33 | ||
| Microbes and Drugs | 33 | ||
| Therapeutic Manipulation of the Microbiota | 34 | ||
| Intestinal Virome | 34 | ||
| Future Directions | 35 | ||
| Key References | 35 | ||
| References | 35.e1 | ||
| 4 Gastrointestinal Hormones and Neurotransmitters | 36 | ||
| Chapter Outline | 36 | ||
| Hormones and Neurotransmitters | 36 | ||
| Definitions | 36 | ||
| Modes of Transmitter Release | 37 | ||
| Endocrine | 37 | ||
| Paracrine | 37 | ||
| Autocrine | 37 | ||
| Neurotransmission | 37 | ||
| Transducing Signals From the Gastrointestinal Lumen | 38 | ||
| Recognizing Signals Through Cell Surface Receptors | 40 | ||
| G Protein–Coupled Receptors | 40 | ||
| Signaling Through Cyclic Adenosine Monophosphate | 40 | ||
| Signaling Through Calcium | 40 | ||
| Enzyme–Coupled Receptors | 40 | ||
| Ion Channel–Coupled Receptors | 41 | ||
| Nutrient Chemosensing | 41 | ||
| Lipids | 41 | ||
| Proteins and Amino Acids | 41 | ||
| Tastants | 42 | ||
| Sensing the Microbiome | 42 | ||
| Other Factors That Stimulate Transmitter Release | 42 | ||
| The Transmitters | 42 | ||
| Gut Neuropeptides | 43 | ||
| Gastrin | 43 | ||
| Cholecystokinin | 44 | ||
| Secretin | 44 | ||
| Vasoactive Intestinal Polypeptide | 44 | ||
| Glucagon | 45 | ||
| Glucose-Dependent Insulinotropic Polypeptide | 45 | ||
| Pancreatic Polypeptide Family | 46 | ||
| Substance P and the Tachykinins | 46 | ||
| Somatostatin | 46 | ||
| Motilin | 47 | ||
| Leptin | 47 | ||
| Ghrelin | 47 | ||
| Neurotransmitters | 47 | ||
| Acetylcholine | 47 | ||
| Catecholamines | 48 | ||
| Dopamine | 48 | ||
| Serotonin | 48 | ||
| Histamine | 48 | ||
| Nitric Oxide | 49 | ||
| Cannabinoids and Other Chemical Transmitters | 49 | ||
| Cannabinoids | 49 | ||
| Adenosine | 50 | ||
| Cytokines | 50 | ||
| The Importance of Hormones and Neurotransmitters | 50 | ||
| Growth and Abnormal Growth of the Gastrointestinal Mucosa | 50 | ||
| Growth Factor Receptors | 51 | ||
| Epidermal Growth Factor | 51 | ||
| Transforming Growth Factor-α | 51 | ||
| Transforming Growth Factor-β | 51 | ||
| Insulin-like Growth Factors | 51 | ||
| Fibroblast Growth Factor and Platelet-Derived Growth Factor | 51 | ||
| Trefoil Factors | 52 | ||
| Diabetes Mellitus and the Gastrointestinal Tract | 52 | ||
| Gastrointestinal Regulation of Appetite | 53 | ||
| Key References | 53 | ||
| References | 54.e1 | ||
| II Nutrition in Gastroenterology | 55 | ||
| 5 Nutritional Principles and Assessment of the Gastroenterology Patient | 57 | ||
| Chapter Outline | 57 | ||
| Basic Nutritional Concepts | 57 | ||
| Energy Stores | 57 | ||
| Energy Metabolism | 57 | ||
| Resting Energy Expenditure | 57 | ||
| Energy Expenditure of Physical Activity | 58 | ||
| Thermic Effect of Feeding | 58 | ||
| Recommended Energy Intake in Hospitalized Patients | 58 | ||
| Methods Incorporating Metabolic Stress Factors | 59 | ||
| Method without a Stress Factor | 59 | ||
| Caloric Delivery and Avoidance of Hyperglycemia | 59 | ||
| Protein | 61 | ||
| Nitrogen Balance | 61 | ||
| Carbohydrate | 62 | ||
| Lipids | 62 | ||
| Essential Fatty Acids | 62 | ||
| Major Minerals | 62 | ||
| Micronutrients | 62 | ||
| Vitamins | 63 | ||
| Trace Minerals | 63 | ||
| Physiologic and Pathophysiologic Factors Affecting Micronutrient Requirements | 70 | ||
| Age | 70 | ||
| Malabsorption and Maldigestion | 70 | ||
| Starvation | 71 | ||
| Malnutrition | 72 | ||
| Protein-Energy Malnutrition | 72 | ||
| Primary versus Secondary Protein-Energy Malnutrition: A Body Compartment Perspective | 73 | ||
| Protein-Energy Malnutrition in Children | 73 | ||
| Kwashiorkor | 74 | ||
| Marasmus | 74 | ||
| Nutritional Dwarfism | 74 | ||
| Physiologic Impairments Caused by Protein-Energy Malnutrition | 75 | ||
| System Effects | 75 | ||
| Gastrointestinal Tract | 75 | ||
| Cardiovascular System | 75 | ||
| Immune System | 75 | ||
| Respiratory System | 75 | ||
| Endocrine System | 75 | ||
| Other Effects | 75 | ||
| Wound Healing | 75 | ||
| Skin | 76 | ||
| Hair | 76 | ||
| Kidneys | 76 | ||
| Bone Marrow | 76 | ||
| Nutritional Assessment Techniques | 76 | ||
| History | 76 | ||
| Weight Loss | 76 | ||
| Food Intake | 76 | ||
| Evidence of Malabsorption | 77 | ||
| Evidence of Specific Nutrient Deficiencies | 77 | ||
| Influence of Disease on Nutrient Requirements | 77 | ||
| Functional Status | 77 | ||
| Physical Examination | 77 | ||
| Hydration Status | 77 | ||
| Tissue Depletion | 77 | ||
| Muscle Function | 77 | ||
| Specific Nutrient Deficiencies | 77 | ||
| Anthropometry | 77 | ||
| Functional Measures of Protein-Calorie Status | 79 | ||
| Biochemical Measures of Protein-Calorie Status | 79 | ||
| Serum Proteins | 79 | ||
| Creatinine-Height Index | 79 | ||
| Discriminant Analyses of Protein-Calorie Status | 79 | ||
| Rapid Screening Tools for Assessment of Targeted Populations | 80 | ||
| Subjective Global Assessment | 80 | ||
| Mini-Nutritional Assessment | 80 | ||
| Aggressive Nutritional Support in the Hospitalized Patient | 81 | ||
| Malnourished Patients Undergoing Major Surgery | 81 | ||
| Patients Hospitalized with Decompensated Alcoholic Liver Disease | 82 | ||
| Patients Undergoing Radiation Therapy | 82 | ||
| Key References | 82 | ||
| References | 82.e1 | ||
| 6 Nutritional Management | 83 | ||
| Chapter Outline | 83 | ||
| Nutrition in Specific Disease States | 83 | ||
| Intestinal Failure (Short Bowel Syndrome) | 83 | ||
| Pancreatitis | 84 | ||
| Crohn’s Disease | 84 | ||
| Liver Disease | 85 | ||
| Diverticular Disease | 86 | ||
| Dumping Syndrome | 86 | ||
| Cancer | 86 | ||
| Obesity | 86 | ||
| Critical Illness | 87 | ||
| Nutritional Therapy | 88 | ||
| Parenteral Nutrition | 88 | ||
| Central Parenteral Nutrition Formulation | 88 | ||
| Peripheral Parenteral Nutrition Formulation | 89 | ||
| Administration | 89 | ||
| Laboratory Testing | 89 | ||
| Metabolic Complications | 90 | ||
| Vascular Access Devices | 90 | ||
| Central Venous Catheter Complications | 91 | ||
| Enteral Nutrition | 91 | ||
| Nasoenteric Tube Access | 91 | ||
| Percutaneous Endoscopic Enteral Access | 93 | ||
| Percutaneous Endoscopic Gastrostomy | 93 | ||
| Indications. | 93 | ||
| Cancer. | 93 | ||
| Stroke. | 93 | ||
| Dementia. | 93 | ||
| Disabling Neurologic Conditions. | 94 | ||
| Procedure. | 94 | ||
| Percutaneous Endoscopic Gastrojejunostomy | 96 | ||
| Direct Percutaneous Jejunostomy | 97 | ||
| Surgical Enteral Access | 98 | ||
| Fluoroscopic Percutaneous Enteral Access | 98 | ||
| Enteral Feeding | 98 | ||
| Water Requirements | 98 | ||
| Advancement of Tube Feedings | 99 | ||
| Enteral Formulations | 99 | ||
| Blenderized Formulations. | 99 | ||
| Standard Polymeric Formulations. | 99 | ||
| Predigested Formulations. | 99 | ||
| Specialty Formulations. | 99 | ||
| Immune-Modulating Formulas. | 99 | ||
| Renal Formulas. | 99 | ||
| Enteral Feeding Complications | 99 | ||
| Oral Diet Therapy | 100 | ||
| Clear Liquid Diets | 100 | ||
| Full Liquid Diets | 100 | ||
| Soft Diets | 100 | ||
| Fiber- and Residue-Restricted Diets | 100 | ||
| High-Fiber Diets | 100 | ||
| Post-gastrectomy and Anti-dumping Diets | 100 | ||
| Low-Fat Diets | 100 | ||
| Acknowledgment | 101 | ||
| Key References | 101 | ||
| References | 101.e1 | ||
| 7 Obesity | 102 | ||
| Chapter Outline | 102 | ||
| Definitions | 103 | ||
| Body Mass Index | 103 | ||
| Central Adiposity | 103 | ||
| Prevalence and Costs | 103 | ||
| Causes | 104 | ||
| Energy Imbalance | 104 | ||
| Environmental Agents | 104 | ||
| Intrauterine Factors | 104 | ||
| Neonatal Environment | 104 | ||
| Adiposity Rebound | 104 | ||
| Drug-Induced Weight Gain | 104 | ||
| Diet | 105 | ||
| Physical Inactivity | 105 | ||
| Smoking | 105 | ||
| Viruses | 105 | ||
| Microbiome | 105 | ||
| Host Agents | 105 | ||
| Genetic Causes | 105 | ||
| Neurophysiologic Factors | 105 | ||
| Pathology and Pathophysiology | 106 | ||
| Fat Cell as an Endocrine Cell | 106 | ||
| Brown Adipose Tissue | 106 | ||
| Visceral and Ectopic Fat | 106 | ||
| Complications and Consequences | 106 | ||
| Diseases and Disorders | 106 | ||
| Disorders Related to Enlarged and Visceral Fat Cells | 106 | ||
| Diabetes | 106 | ||
| Lipid Derangements | 106 | ||
| Cardiovascular Diseases | 107 | ||
| Hypertension | 107 | ||
| Kidney Disease | 107 | ||
| Gallbladder Disease | 107 | ||
| Liver Disease | 107 | ||
| Gastroesophageal Reflux Disease | 107 | ||
| Cancer | 107 | ||
| Endocrine Effects | 108 | ||
| Pneumonia | 108 | ||
| Disorders Associated with Increased Fat Mass | 108 | ||
| Obstructive Sleep Apnea | 108 | ||
| Diseases of the Bones, Joints, Muscles, Connective Tissue, and Skin | 108 | ||
| Psychosocial Dysfunction | 109 | ||
| Death | 109 | ||
| Benefits of Weight Loss | 109 | ||
| Evaluation | 109 | ||
| History | 109 | ||
| Physical Examination | 110 | ||
| Laboratory Studies | 111 | ||
| Prevention | 111 | ||
| Treatment | 111 | ||
| Diets | 111 | ||
| Popular Diets | 112 | ||
| Low-Fat Diets | 112 | ||
| Low Energy Density Diets | 112 | ||
| Low-Carbohydrate Diets | 112 | ||
| Very Low-Calorie Diets | 112 | ||
| Commercial Programs | 113 | ||
| Lifestyle Modification | 113 | ||
| Exercise | 113 | ||
| Pharmacotherapy | 113 | ||
| Mechanisms of Drug Action | 114 | ||
| FDA-Approved Medications | 114 | ||
| Orlistat | 114 | ||
| Sympathomimetic Amines | 115 | ||
| Lorcaserin | 115 | ||
| Topiramate and Phentermine Extended Release | 115 | ||
| Bupropion and Naltrexone | 116 | ||
| Drugs Approved for an Indication Other than Obesity | 116 | ||
| Metformin | 116 | ||
| Bupropion | 116 | ||
| Glucagon-like Peptide-1 Agonists | 117 | ||
| Exenatide | 117 | ||
| Liraglutide | 117 | ||
| Pramlintide | 117 | ||
| Pramlintide and Phentermine | 118 | ||
| Zonisamide | 118 | ||
| Surgery | 118 | ||
| Key References | 118 | ||
| References | 118.e1 | ||
| 8 Surgical and Endoscopic Treatment of Obesity | 119 | ||
| Chapter Outline | 119 | ||
| Evaluation and Selection of Bariatric Surgery Candidates | 120 | ||
| Surgical Techniques | 120 | ||
| Surgical Complications | 122 | ||
| Nutritional Deficiencies | 123 | ||
| Outcomes | 123 | ||
| Endoscopic Management of Bariatric Surgical Complications | 124 | ||
| Ulceration | 124 | ||
| Postoperative Gastrointestinal Bleeding | 124 | ||
| Stenosis | 125 | ||
| Foreign Body Complications | 125 | ||
| Leaks and Fistulae | 126 | ||
| Pancreaticobiliary Disease | 127 | ||
| Weight Regain and Dilated Gastrojejunal Anastomosis | 127 | ||
| Endoscopic Treatments for Obesity | 127 | ||
| Key References | 129 | ||
| References | 129.e1 | ||
| 9 Feeding and Eating Disorders | 130 | ||
| Chapter Outline | 130 | ||
| Epidemiology | 130 | ||
| Causative Factors | 131 | ||
| Satiety | 131 | ||
| Appetite | 131 | ||
| Energy Storage | 131 | ||
| Onset and Course | 132 | ||
| Evaluation | 132 | ||
| Diagnosis of Specific Disorders | 132 | ||
| Anorexia Nervosa | 133 | ||
| Binge Eating Disorder | 134 | ||
| Other Specified Feeding or Eating Disorder and Unspecified Feeding or Eating Disorder | 134 | ||
| Avoidant/Restrictive Food Intake Disorder (ARFID) | 134 | ||
| Pica | 135 | ||
| Rumination Disorder | 135 | ||
| Differential Diagnosis | 135 | ||
| Nutritional, Medical, and Laboratory Evaluation | 136 | ||
| Nutritional Evaluation | 136 | ||
| Medical Evaluation | 137 | ||
| Laboratory Evaluation | 138 | ||
| Gastrointestinal Abnormalities Associated with Eating Disorders | 138 | ||
| Management of Eating Disorders in the Adult | 142 | ||
| Psychiatric Treatment | 142 | ||
| Psychotherapy | 143 | ||
| Pharmacotherapy | 144 | ||
| Weight Management | 144 | ||
| Medical Management of GI Symptoms | 145 | ||
| Key References | 147 | ||
| References | 147.e1 | ||
| 10 Food Allergies | 148 | ||
| Chapter Outline | 148 | ||
| Definitions and Prevalence | 148 | ||
| Definitions | 148 | ||
| Prevalence | 148 | ||
| Pathogenesis | 149 | ||
| Clinical Features | 151 | ||
| IgE-Mediated Disorders | 152 | ||
| Pollen-Food Allergy Syndrome | 152 | ||
| Gastrointestinal Allergy | 152 | ||
| Infantile Colic | 152 | ||
| Mixed IgE- and Non–IgE-Mediated Disorders | 152 | ||
| Eosinophilic Esophagitis | 153 | ||
| Eosinophilic Gastroenteritis | 153 | ||
| Allergic Eosinophilic Proctocolitis | 153 | ||
| Non–IgE-Mediated Disorders | 154 | ||
| Food Protein-Induced Enterocolitis Syndrome | 154 | ||
| Dietary Protein-Induced Enteropathy | 154 | ||
| Celiac Disease | 154 | ||
| Dermatitis Herpetiformis | 155 | ||
| Other Gastrointestinal Disorders | 155 | ||
| Diagnosis | 155 | ||
| Treatment and Natural History | 155 | ||
| Key References | 157 | ||
| References | 157.e1 | ||
| III Symptoms, Signs, and Biopsychosocial Issues | 159 | ||
| 11 Acute Abdominal Pain | 161 | ||
| Chapter Outline | 161 | ||
| Anatomy | 161 | ||
| Visceral Pain | 161 | ||
| Somatic-Parietal Pain | 164 | ||
| Referred Pain | 164 | ||
| Evaluation | 164 | ||
| Approach to Acute Care | 165 | ||
| History | 165 | ||
| Chronology | 165 | ||
| Location | 166 | ||
| Intensity and Character | 166 | ||
| Aggravating and Alleviating Factors | 166 | ||
| Associated Symptoms | 166 | ||
| Past Medical History | 166 | ||
| Physical Examination | 166 | ||
| Abdominal Examination | 167 | ||
| Genital, Rectal, and Pelvic Examinations | 167 | ||
| Laboratory Data | 167 | ||
| Imaging Studies | 167 | ||
| CT | 167 | ||
| US | 167 | ||
| Other Diagnostic Tests | 168 | ||
| Causes | 168 | ||
| Acute Appendicitis | 168 | ||
| Acute Biliary Disease | 169 | ||
| Small Bowel Obstruction | 169 | ||
| Acute Diverticulitis | 170 | ||
| Acute Pancreatitis | 170 | ||
| Perforated Peptic Ulcer | 170 | ||
| Acute Mesenteric Ischemia | 171 | ||
| Abdominal Aortic Aneurysm | 171 | ||
| Abdominal Compartment Syndrome | 171 | ||
| Other Intra-abdominal Causes | 172 | ||
| Extra-abdominal and Systemic Causes | 172 | ||
| Special Circumstances | 172 | ||
| Extremes of Age | 172 | ||
| Pregnancy | 173 | ||
| Immunocompromised Hosts | 173 | ||
| Pharmacologic Management | 174 | ||
| Key References | 174 | ||
| References | 174.e1 | ||
| 12 Chronic Abdominal Pain | 175 | ||
| Chapter Outline | 175 | ||
| Definition and Clinical Approach | 175 | ||
| Abdominal Wall Pain | 176 | ||
| Anterior Cutaneous Nerve Entrapment and Myofascial Pain Syndromes | 176 | ||
| Slipping Rib Syndrome | 177 | ||
| Thoracic Nerve Radiculopathy | 177 | ||
| Functional Abdominal Pain Syndrome | 177 | ||
| Epidemiology | 177 | ||
| Pathophysiology | 178 | ||
| Ascending Visceral Pain Transmission | 178 | ||
| Descending Modulation of Pain | 179 | ||
| Visceral Sensitization | 179 | ||
| Biochemical Mechanisms of Sensitization | 179 | ||
| Role of the Central Nervous System | 179 | ||
| Clinical Implications | 180 | ||
| Clinical Features | 180 | ||
| History | 180 | ||
| Patient Behavior | 180 | ||
| Physical Examination | 181 | ||
| Diagnosis and Differential Diagnosis | 181 | ||
| Treatment | 181 | ||
| Establishing a Successful Patient-Physician Relationship | 181 | ||
| Instituting a Treatment Plan | 182 | ||
| Pharmacotherapy | 182 | ||
| Mental Health Referral and Psychological Treatments | 183 | ||
| Role of Laparoscopy with Lysis of Adhesions | 183 | ||
| Narcotic Bowel Syndrome | 183 | ||
| Key References | 184 | ||
| References | 184.e1 | ||
| 13 Symptoms of Esophageal Disease | 185 | ||
| Chapter Outline | 185 | ||
| Dysphagia | 185 | ||
| Pathophysiology | 185 | ||
| Differential Diagnosis and Approach | 186 | ||
| Oropharyngeal Dysphagia | 186 | ||
| Esophageal Dysphagia | 186 | ||
| Odynophagia | 188 | ||
| Globus Sensation | 189 | ||
| Pathophysiology | 189 | ||
| Approach | 189 | ||
| Hiccups | 189 | ||
| Chest Pain of Esophageal Origin | 189 | ||
| Pathophysiology | 190 | ||
| Approach | 190 | ||
| Heartburn and Regurgitation | 191 | ||
| Pathophysiology | 191 | ||
| Approach | 192 | ||
| Extraesophageal Symptoms of GERD | 192 | ||
| Key References | 193 | ||
| References | 193.e1 | ||
| 14 Dyspepsia | 194 | ||
| Chapter Outline | 194 | ||
| Definition | 194 | ||
| Organic Causes of Dyspepsia | 194 | ||
| Intolerance to Food or Drugs | 195 | ||
| PUD | 195 | ||
| GERD | 195 | ||
| Gastric and Esophageal Cancer | 195 | ||
| Pancreatic and Biliary Tract Disorders | 195 | ||
| Other GI or Systemic Disorders | 196 | ||
| Functional Dyspepsia | 196 | ||
| Dyspepsia Symptom Complex | 196 | ||
| Pattern and Heterogeneity | 196 | ||
| Subgroups | 196 | ||
| Overlap with Heartburn and IBS | 197 | ||
| Epidemiology | 198 | ||
| Pathophysiology | 198 | ||
| Delayed Gastric Emptying | 198 | ||
| Impaired Gastric Accommodation to a Meal | 198 | ||
| Hypersensitivity to Gastric Distension | 198 | ||
| Altered Duodenal Sensitivity to Lipids or Acid | 199 | ||
| Other Mechanisms | 199 | ||
| Pathogenic Factors | 199 | ||
| Genetic Predisposition | 199 | ||
| Infection | 199 | ||
| Hp Infection | 199 | ||
| Postinfection Functional Dyspepsia | 199 | ||
| Psychosocial Factors | 199 | ||
| Approach to Uninvestigated Dyspepsia | 200 | ||
| History and Physical Examination | 200 | ||
| Laboratory Testing | 200 | ||
| Initial Management Strategies | 200 | ||
| Prompt Endoscopy and Directed Treatment | 200 | ||
| Test and Treat for Hp Infection | 201 | ||
| Empirical Antisecretory Drug Therapy | 201 | ||
| Recommendations | 201 | ||
| Additional Investigations | 202 | ||
| Treatment of Functional Dyspepsia | 202 | ||
| General Measures | 202 | ||
| Pharmacologic Treatment | 202 | ||
| Acid-Suppressive Drugs | 202 | ||
| Eradication of Hp Infection | 202 | ||
| Prokinetic Agents | 202 | ||
| Antidepressants | 203 | ||
| Other Pharmacotherapeutic Approaches | 203 | ||
| New Drug Development | 203 | ||
| Psychological Interventions | 204 | ||
| Recommendations | 205 | ||
| Key References | 206 | ||
| References | 206.e1 | ||
| 15 Nausea and Vomiting | 207 | ||
| Chapter Outline | 207 | ||
| Pathophysiology | 207 | ||
| Clinical Characteristics | 208 | ||
| Causes | 208 | ||
| Acute Vomiting | 209 | ||
| Acute Intestinal Obstruction | 209 | ||
| Gastric Outlet Obstruction | 209 | ||
| Intestinal Infarction | 210 | ||
| Extraintestinal Causes | 210 | ||
| Toxins and Drugs | 210 | ||
| Metabolic Causes | 210 | ||
| Infectious Causes | 210 | ||
| Neurologic Causes | 210 | ||
| Postoperative Nausea and Vomiting | 211 | ||
| Chronic or Relapsing Vomiting | 211 | ||
| Partial Intestinal Obstruction | 211 | ||
| Gastric Outlet Obstruction | 211 | ||
| GI Motility Disorders | 211 | ||
| Neurologic Disorders | 211 | ||
| Nausea and Vomiting During Pregnancy | 212 | ||
| Functional Vomiting | 212 | ||
| Cyclic Vomiting Syndrome | 213 | ||
| Superior Mesenteric Artery Syndrome | 213 | ||
| Rumination Syndrome | 214 | ||
| Evaluation | 214 | ||
| Acute Vomiting | 214 | ||
| Basic Tests | 214 | ||
| Imaging | 214 | ||
| Additional Tests | 215 | ||
| Chronic Vomiting | 215 | ||
| Esophageal Manometry | 216 | ||
| Measurement of Gastric Emptying | 216 | ||
| Cutaneous Electrogastrography | 216 | ||
| GI Manometry | 216 | ||
| Autonomic Function Tests | 216 | ||
| Histopathologic Studies | 216 | ||
| Complications | 216 | ||
| Emetic Injuries to the Esophagus and Stomach | 216 | ||
| Spasm of the Glottis and Aspiration Pneumonia | 217 | ||
| Fluid, Electrolyte, and Metabolic Alterations | 217 | ||
| Nutritional Deficiencies | 217 | ||
| Treatment | 217 | ||
| Correction of Metabolic Complications | 217 | ||
| Pharmacologic Treatment | 217 | ||
| Central Antiemetic Agents | 217 | ||
| Dopamine D2 Receptor Antagonists | 217 | ||
| Benzamides. | 217 | ||
| Benzimidazole Derivatives. | 217 | ||
| Phenothiazines and Butyrophenones | 218 | ||
| Antihistamines and Antimuscarinic Agents | 218 | ||
| Serotonin Antagonists | 218 | ||
| Glucocorticoids | 218 | ||
| Cannabinoids | 218 | ||
| Neurokinin-1 Receptor Antagonists | 218 | ||
| Adjuvant Agents and Therapies | 218 | ||
| Gastric Prokinetic Agents | 219 | ||
| Serotonin 5-HT4 Receptor Agonists | 219 | ||
| Motilin Receptor Agonists | 219 | ||
| Gastric Electrical Stimulation | 219 | ||
| Key References | 219 | ||
| References | 220.e1 | ||
| 16 Diarrhea | 221 | ||
| Chapter Outline | 221 | ||
| Definition | 221 | ||
| Pathophysiology | 222 | ||
| Osmotic Diarrhea | 222 | ||
| Secretory Diarrhea | 223 | ||
| Complex Diarrhea | 224 | ||
| Clinical Classification | 226 | ||
| Acute versus Chronic Diarrhea | 226 | ||
| Large-Volume versus Small-Volume Diarrhea | 226 | ||
| Osmotic versus Secretory Diarrhea | 226 | ||
| Watery versus Fatty versus Inflammatory Diarrhea | 226 | ||
| Epidemiologic Features | 226 | ||
| Differential Diagnosis | 227 | ||
| Evaluation | 229 | ||
| History | 229 | ||
| Physical Examination | 229 | ||
| Further Evaluation of Acute Diarrhea | 230 | ||
| Further Evaluation of Chronic Diarrhea | 231 | ||
| Chronic Watery Diarrhea | 232 | ||
| Chronic Inflammatory Diarrhea | 234 | ||
| Chronic Fatty Diarrhea | 234 | ||
| Treatment | 235 | ||
| Empirical Therapy of Acute Diarrhea | 235 | ||
| Empirical Therapy of Chronic Diarrhea | 235 | ||
| Selected Diarrheal Syndromes | 236 | ||
| IBS and Functional Diarrhea | 236 | ||
| Microscopic Colitis | 237 | ||
| Postsurgical Diarrhea | 237 | ||
| Diarrhea after Gastric Surgery | 237 | ||
| Diarrhea after Bowel Resection | 238 | ||
| Ileostomy Diarrhea | 238 | ||
| Postcholecystectomy Diarrhea | 238 | ||
| Bile Acid–Induced Diarrhea | 238 | ||
| Diarrhea in Hospitalized Patients | 238 | ||
| Factitious Diarrhea | 239 | ||
| Idiopathic Secretory Diarrhea | 240 | ||
| Diarrhea of Obscure Origin | 240 | ||
| Key References | 240 | ||
| References | 241.e1 | ||
| 17 Intestinal Gas | 242 | ||
| Chapter Outline | 242 | ||
| Composition and Volume of GI Gas | 242 | ||
| Gas Metabolism and Excretion | 242 | ||
| Diffusion of Gas Between the Intestinal Lumen and Blood | 242 | ||
| Mouth to Stomach | 243 | ||
| Small Intestine | 243 | ||
| Colon | 243 | ||
| Passage of Fermentable Products into the Colon | 244 | ||
| Metabolic Activity of Colonic Microflora | 245 | ||
| Odoriferous Gases | 245 | ||
| Anal Gas Evacuation | 245 | ||
| Intestinal Propulsion, Accommodation, and Tolerance to Gas | 246 | ||
| Clinical Gas Problems | 246 | ||
| Repetitive Eructation | 247 | ||
| Vol-2 | Vol-2-Cover | ||
| Front cover | Vol-2-Cover | ||
| IFC_Vol.2 | Vol-2-IFC2 | ||
| Sleisenger and Fordtran’s Gastrointestinal and Liver Disease | Vol-2-iii | ||
| Copyright page | Vol-2-iv | ||
| Dedication | Vol-2-v | ||
| Contributors | Vol-2-vii | ||
| Foreword | Vol-2-xix | ||
| Preface | Vol-2-xxi | ||
| Table of Contents | Vol-2-xxiii | ||
| Video Contents | Vol-2-xxix | ||
| Abbreviation List | Vol-2-xxxi | ||
| IX Liver | 1215 | ||
| 71 Embryology, Anatomy, Histology, and Developmental Anomalies of the Liver | 1217 | ||
| Chapter Outline | 1217 | ||
| Embryology | 1217 | ||
| Hepatic Stem Cells and Maturational Lineages | 1218 | ||
| Vascular Development | 1219 | ||
| Anatomy | 1219 | ||
| Nerves | 1220 | ||
| Lymphatics | 1220 | ||
| Histology | 1220 | ||
| Organization of the Liver Parenchyma | 1221 | ||
| Developmental Anomalies (See Chapter 62) | 1222 | ||
| Riedel’s Lobe | 1222 | ||
| Abernethy Malformation | 1222 | ||
| Key References | 1222 | ||
| References | 1222.e1 | ||
| 72 Liver Physiology and Energy Metabolism | 1223 | ||
| Chapter Outline | 1223 | ||
| Liver Cell Types and Organization | 1223 | ||
| Parenchymal Cells | 1223 | ||
| Hepatocytes | 1223 | ||
| Plasma Membranes | 1223 | ||
| Cell Junctions. | 1224 | ||
| Cytoskeleton | 1224 | ||
| Nucleus | 1224 | ||
| Transport between the Nucleus and Cytoplasm. | 1224 | ||
| Endoplasmic Reticulum | 1225 | ||
| Golgi Complex | 1225 | ||
| Lysosomes | 1225 | ||
| Mitochondria | 1225 | ||
| Peroxisomes | 1225 | ||
| Exocytosis and Endocytosis | 1225 | ||
| Bile Duct Epithelial Cells | 1226 | ||
| Sinusoidal Cells | 1226 | ||
| Hepatic Sinusoidal Endothelial Cells | 1226 | ||
| Kupffer Cells | 1227 | ||
| Perisinusoidal Cells | 1227 | ||
| Hepatic Stellate Cells | 1227 | ||
| Pit Cells | 1227 | ||
| Integration of the Functions of the Different Cell Types | 1227 | ||
| Cell-Matrix Interactions | 1228 | ||
| Components of the Extracellular Matrix | 1228 | ||
| Regeneration and Apoptosis of Liver Cells | 1228 | ||
| Regeneration | 1228 | ||
| Gene Expression During Regeneration | 1228 | ||
| Immediate Early Genes | 1229 | ||
| Delayed Early Genes | 1229 | ||
| Cell Cycle Genes | 1230 | ||
| Integration of Cytokine and Growth Factors in Regeneration | 1230 | ||
| Apoptosis | 1230 | ||
| Autophagy | 1231 | ||
| Protein Synthesis and Degradation in the Liver | 1232 | ||
| Hepatic Gene Expression | 1232 | ||
| Nuclear Receptors | 1232 | ||
| Protein Folding | 1232 | ||
| Protein Catabolism | 1233 | ||
| Hepatic Nutrient Metabolism | 1234 | ||
| Carbohydrate | 1234 | ||
| Regulation of Glucose Uptake and Efflux from the Hepatocyte | 1234 | ||
| Formation of Glucose-6-Phosphate | 1234 | ||
| Conversion of Glucose-6-Phosphate to Glucose | 1235 | ||
| Hepatic Metabolism of Galactose and Fructose | 1236 | ||
| Glycogen Formation | 1236 | ||
| Regulation of Glycolytic-Gluconeogenic Pathways | 1236 | ||
| Carbohydrate Metabolism in Cirrhosis | 1237 | ||
| Lipid | 1237 | ||
| Fatty Acid Synthesis | 1237 | ||
| Beta Oxidation of Fatty Acids | 1237 | ||
| Mitochondrial Beta Oxidation | 1237 | ||
| Peroxisomal Beta Oxidation | 1238 | ||
| Lipoproteins | 1238 | ||
| Types | 1238 | ||
| Apolipoproteins | 1239 | ||
| Lipolytic Enzymes and Lipid Transport Proteins | 1239 | ||
| Intestinal and Hepatic Lipid Transport | 1239 | ||
| Transport of ApoB-Containing Lipoproteins | 1240 | ||
| Transport of ApoA-Containing High-Density Lipoproteins | 1241 | ||
| Lipoprotein Receptors | 1241 | ||
| Low-Density Lipoprotein Receptor | 1241 | ||
| Very-Low-Density Lipoprotein Receptor | 1241 | ||
| Chylomicron Remnant Receptor | 1241 | ||
| Low-Density Lipoprotein Scavenger Receptor | 1241 | ||
| High-Density Lipoprotein Receptor | 1241 | ||
| Derangement of Lipid Metabolism in Liver Disease | 1242 | ||
| Key References | 1242 | ||
| References | 1242.e1 | ||
| 73 Liver Chemistry and Function Tests | 1243 | ||
| Chapter Outline | 1243 | ||
| Bilirubin (See Chapter 21) | 1243 | ||
| Metabolism | 1243 | ||
| Measurement | 1244 | ||
| Approach to the Patient with an Elevated Level | 1244 | ||
| Aminotransferases | 1245 | ||
| Approach to the Patient with an Elevated Level | 1246 | ||
| Alkaline Phosphatase | 1247 | ||
| GGTP | 1247 | ||
| 5′-Nucleotidase | 1248 | ||
| Approach to the Patient with an Elevated Level | 1248 | ||
| Tests of Hepatic Synthetic Function | 1249 | ||
| Albumin | 1249 | ||
| Prothrombin Time | 1250 | ||
| Tests to Detect Hepatic Fibrosis | 1250 | ||
| Quantitative Liver Function Tests | 1251 | ||
| Indocyanine Green Clearance | 1251 | ||
| Galactose Elimination Capacity | 1251 | ||
| Caffeine Clearance | 1251 | ||
| Lidocaine Metabolite Formation | 1251 | ||
| Aminopyrine Breath Test | 1251 | ||
| Bile Acids | 1252 | ||
| Specific Applications of Liver Biochemical Testing | 1252 | ||
| Drug-Induced Liver Injury | 1252 | ||
| Surgical Candidacy and Organ Allocation | 1252 | ||
| Key References | 1253 | ||
| References | 1253.e1 | ||
| 74 Overview of Cirrhosis | 1254 | ||
| Chapter Outline | 1254 | ||
| Pathogenesis | 1254 | ||
| Diagnosis | 1254 | ||
| Natural History | 1257 | ||
| Prognosis | 1259 | ||
| Treatment | 1259 | ||
| Reversal of Fibrosis | 1260 | ||
| Key References | 1260 | ||
| References | 1260.e1 | ||
| 75 Hemochromatosis | 1261 | ||
| Chapter Outline | 1261 | ||
| Causes of Iron Overload | 1261 | ||
| Pathophysiology | 1262 | ||
| Intestinal Iron Absorption | 1262 | ||
| Hepcidin | 1262 | ||
| HFE Protein | 1263 | ||
| Iron-Induced Tissue Injury and Fibrosis | 1264 | ||
| Clinical Features | 1264 | ||
| Diagnosis | 1265 | ||
| Treatment and Prognosis | 1268 | ||
| Family Screening | 1269 | ||
| Key References | 1269 | ||
| References | 1269.e1 | ||
| 76 Wilson Disease | 1270 | ||
| Chapter Outline | 1270 | ||
| Copper Metabolism | 1270 | ||
| Molecular Pathogenesis | 1270 | ||
| Pathology | 1272 | ||
| Clinical Features | 1272 | ||
| Hepatic Presentation | 1273 | ||
| Neurologic Presentation | 1273 | ||
| Psychiatric Presentation | 1273 | ||
| Ocular Signs | 1273 | ||
| Involvement of Other Systems | 1273 | ||
| Diagnosis | 1274 | ||
| Tests | 1274 | ||
| Approach | 1275 | ||
| Mutation Analysis | 1275 | ||
| Presymptomatic Diagnosis of First-Degree Relatives | 1276 | ||
| Treatment | 1276 | ||
| Prognosis | 1278 | ||
| Key References | 1278 | ||
| References | 1279.e1 | ||
| 77 Other Inherited Metabolic Disorders of the Liver | 1280 | ||
| Chapter Outline | 1280 | ||
| Clinical Features of Metabolic Liver Disease | 1280 | ||
| α1-Antitrypsin Deficiency | 1281 | ||
| Pathophysiology | 1281 | ||
| Clinical Features | 1281 | ||
| Histopathology | 1282 | ||
| Diagnosis | 1282 | ||
| Treatment | 1282 | ||
| Glycogen Storage Diseases | 1283 | ||
| Type I | 1283 | ||
| Clinical Features | 1283 | ||
| Hepatic Involvement | 1284 | ||
| Diagnosis | 1284 | ||
| Treatment | 1284 | ||
| Type III | 1285 | ||
| Clinical Features | 1285 | ||
| Treatment | 1285 | ||
| Type IV | 1285 | ||
| Congenital Disorders of Glycosylation | 1285 | ||
| Porphyrias | 1287 | ||
| Pathophysiology | 1287 | ||
| Acute Porphyrias | 1287 | ||
| Cutaneous Porphyrias | 1288 | ||
| Hepatic Involvement | 1289 | ||
| Diagnosis | 1289 | ||
| Treatment | 1290 | ||
| Tyrosinemia | 1290 | ||
| Pathophysiology | 1290 | ||
| Clinical and Pathologic Features | 1291 | ||
| Diagnosis | 1291 | ||
| Treatment | 1292 | ||
| Urea Cycle Defects | 1292 | ||
| Pathophysiology | 1292 | ||
| Clinical Features | 1293 | ||
| Diagnosis | 1294 | ||
| Treatment | 1294 | ||
| Arginase Deficiency | 1295 | ||
| Bile Acid Synthesis and Transport Defects | 1295 | ||
| Bile Acid Synthesis Defects | 1296 | ||
| Diagnosis | 1296 | ||
| Disorders of Enzymes Involved in Modification of the Steroid Ring | 1296 | ||
| Disorders of Enzymes Involved in Side-Chain Modification | 1297 | ||
| Peroxisomal Disorders | 1297 | ||
| Bile Acid Transport Defects | 1298 | ||
| Treatment | 1299 | ||
| CF | 1299 | ||
| Clinical and Pathologic Features | 1299 | ||
| Pathophysiology | 1299 | ||
| Diagnosis | 1300 | ||
| Treatment | 1300 | ||
| Mitochondrial Liver Diseases | 1300 | ||
| Key References | 1301 | ||
| References | 1301.e1 | ||
| 78 Hepatitis A | 1302 | ||
| Chapter Outline | 1302 | ||
| Virology | 1302 | ||
| Epidemiology | 1303 | ||
| Pathogenesis | 1304 | ||
| Clinical Features | 1304 | ||
| Fulminant Hepatitis A | 1305 | ||
| Extrahepatic Manifestations | 1305 | ||
| Autoimmune Hepatitis after Acute Hepatitis A | 1305 | ||
| Diagnosis | 1305 | ||
| Prevention and Treatment | 1306 | ||
| Immunization against Hepatitis A Virus in Patients with Chronic Illnesses | 1307 | ||
| Key References | 1308 | ||
| References | 1308.e1 | ||
| 79 Hepatitis B | 1309 | ||
| Chapter Outline | 1309 | ||
| Epidemiology | 1309 | ||
| Geographic Distribution and Sources of Infection | 1309 | ||
| Infectivity | 1310 | ||
| Prevalence | 1310 | ||
| Clinical Outcomes | 1310 | ||
| Acute Hepatitis B | 1310 | ||
| Chronic Hepatitis B | 1311 | ||
| Virology | 1311 | ||
| Viral Replication | 1311 | ||
| Genotypes | 1311 | ||
| Mutations | 1312 | ||
| Hepatitis B Surface Antigen Gene | 1312 | ||
| Precore, Basal Core Promoter, and Core Genes | 1314 | ||
| HBV DNA Polymerase | 1314 | ||
| Pathogenesis | 1314 | ||
| Natural History | 1315 | ||
| Serum ALT as a Surrogate Marker for Disease Activity | 1316 | ||
| HBV DNA Level and Long-Term Complications | 1316 | ||
| Clinical and Pathologic Features | 1317 | ||
| Acute Hepatitis B | 1317 | ||
| Chronic Hepatitis B | 1317 | ||
| Extrahepatic Manifestations | 1317 | ||
| Arthritis-Dermatitis | 1317 | ||
| Polyarteritis Nodosa | 1317 | ||
| Glomerulonephritis | 1317 | ||
| Cryoglobulinemia | 1318 | ||
| Histopathologic Features | 1318 | ||
| Acute Flares | 1318 | ||
| Spontaneous Flares | 1318 | ||
| Immunosuppressive Therapy–Induced Flares | 1319 | ||
| Antiviral Therapy–Induced Flares | 1320 | ||
| During Interferon Therapy. | 1320 | ||
| During Nucleos(t)ide Analog Therapy. | 1321 | ||
| After Withdrawal of Nucleos(t)ide Analog. | 1321 | ||
| During Antiretroviral Therapy. | 1321 | ||
| Flares Associated with Genotypic Variation | 1321 | ||
| Flares Caused by Infection with Other Viruses | 1321 | ||
| Diagnosis | 1321 | ||
| Treatment | 1322 | ||
| Goals | 1322 | ||
| Cultural Barriers | 1323 | ||
| Choice of Agent | 1323 | ||
| Definitions of Response | 1323 | ||
| Nucleoside and Nucleotide Analogs | 1324 | ||
| Lamivudine | 1324 | ||
| Adefovir Dipivoxil | 1325 | ||
| Entecavir | 1325 | ||
| Telbivudine | 1325 | ||
| Tenofovir Disoproxil Fumarate | 1325 | ||
| Emtricitabine | 1325 | ||
| HBV DNA Monitoring | 1325 | ||
| Drug Failure | 1326 | ||
| Interferon | 1326 | ||
| Combination Interferon and Nucleos(t)ide Analog Therapy | 1326 | ||
| Guidelines | 1326 | ||
| Special Populations | 1327 | ||
| Pregnant Women | 1327 | ||
| Severe Acute Hepatitis | 1327 | ||
| Cirrhosis | 1328 | ||
| HBV-HIV Coinfection | 1328 | ||
| HBV-HCV Coinfection | 1328 | ||
| Urgent Treatment | 1328 | ||
| Prevention | 1329 | ||
| Hepatitis B Immune Globulin | 1329 | ||
| Hepatitis B Vaccine | 1329 | ||
| Vaccination Schedule | 1329 | ||
| Postexposure and Perinatal Prophylaxis | 1329 | ||
| Bivalent Vaccine | 1330 | ||
| Recommendations | 1330 | ||
| Key References | 1330 | ||
| References | 1331.e1 | ||
| 80 Hepatitis C* | 1332 | ||
| Chapter Outline | 1332 | ||
| Virology | 1332 | ||
| Structure | 1332 | ||
| Genomic Organization | 1333 | ||
| Viral Replication and Life Cycle | 1333 | ||
| Virus Protein Function | 1334 | ||
| Genotypes and Quasispecies | 1335 | ||
| Epidemiology | 1336 | ||
| Incidence and Prevalence | 1336 | ||
| Transmission | 1336 | ||
| Percutaneous Transmission | 1336 | ||
| Nonpercutaneous Transmission | 1337 | ||
| Sporadic HCV Infection | 1337 | ||
| Pathogenesis | 1337 | ||
| Viral Mechanisms | 1337 | ||
| Immune-Mediated Mechanisms | 1337 | ||
| Clinical Features | 1338 | ||
| Acute Hepatitis C | 1338 | ||
| Chronic Hepatitis C | 1339 | ||
| Extrahepatic Manifestations | 1339 | ||
| Diagnosis | 1340 | ||
| Indirect Assays | 1340 | ||
| Direct Assays | 1340 | ||
| HCV Genotype | 1340 | ||
| Selection of Serologic and Virologic Tests | 1341 | ||
| Liver Biopsy and Noninvasive Assessment of Fibrosis | 1341 | ||
| Natural History | 1343 | ||
| Factors Associated with Progression | 1343 | ||
| Hepatocellular Carcinoma | 1344 | ||
| Treatment | 1344 | ||
| Goals | 1345 | ||
| Virologic Response | 1345 | ||
| Drugs | 1345 | ||
| Interferons | 1345 | ||
| Ribavirin | 1345 | ||
| Direct-Acting Antiviral Agents | 1346 | ||
| Acute Hepatitis C | 1346 | ||
| Chronic Hepatitis C | 1346 | ||
| Pegylated Interferon and Ribavirin | 1346 | ||
| Pegylated Interferon, Ribavirin, and a First-Generation Protease Inhibitor | 1347 | ||
| Pegylated Interferon, Ribavirin, and Other Direct-Acting Antiviral Agents | 1348 | ||
| Interferon-Free Therapies | 1349 | ||
| Indications and Contraindications | 1349 | ||
| Monitoring and Safety | 1350 | ||
| HCV-HIV Coinfection | 1351 | ||
| Liver Transplant Recipients | 1351 | ||
| Key References | 1352 | ||
| References | 1352.e1 | ||
| 81 Hepatitis D | 1353 | ||
| Chapter Outline | 1353 | ||
| Epidemiology | 1353 | ||
| Virology | 1354 | ||
| Pathogenesis | 1355 | ||
| Diagnosis | 1355 | ||
| HDV RNA | 1355 | ||
| Hepatitis D Antigen | 1356 | ||
| Antibody to HDV | 1356 | ||
| Natural History | 1357 | ||
| Clinical Features | 1357 | ||
| Treatment | 1358 | ||
| Interferon | 1358 | ||
| Combination Antiviral Therapy | 1358 | ||
| Novel Drugs | 1359 | ||
| Prevention | 1359 | ||
| Key References | 1359 | ||
| References | 1359.e1 | ||
| 82 Hepatitis E | 1360 | ||
| Chapter Outline | 1360 | ||
| Virology | 1360 | ||
| Epidemiology | 1360 | ||
| Genotypes 1 and 2 | 1361 | ||
| Genotypes 3 and 4 | 1362 | ||
| Pathogenesis | 1362 | ||
| Clinical Features | 1364 | ||
| Acute Hepatitis E | 1364 | ||
| Chronic Hepatitis E | 1364 | ||
| Diagnosis | 1364 | ||
| Treatment and Prevention | 1365 | ||
| Key References | 1365 | ||
| References | 1365.e1 | ||
| 83 Hepatitis Caused by Other Viruses | 1366 | ||
| Chapter Outline | 1366 | ||
| Hepatitis G and GB Agent Infection | 1366 | ||
| Virology | 1366 | ||
| Epidemiology | 1367 | ||
| Clinical Features | 1367 | ||
| Diagnosis | 1367 | ||
| GB Virus Type C and HIV | 1367 | ||
| Treatment | 1368 | ||
| TT Virus Infection | 1368 | ||
| Virology | 1368 | ||
| Epidemiology | 1369 | ||
| Clinical Features | 1369 | ||
| Treatment | 1369 | ||
| Sanban, Yonban, and SEN Virus and TTV-like Minivirus Infections | 1369 | ||
| Systemic Viral Infections That May Involve the Liver | 1369 | ||
| EBV | 1369 | ||
| Cytomegalovirus | 1370 | ||
| HSV | 1371 | ||
| Varicella-Zoster Virus | 1372 | ||
| Other Viruses | 1372 | ||
| Key References | 1372 | ||
| References | 1373.e1 | ||
| 84 Bacterial, Parasitic, and Fungal Infections of the Liver, Including Liver Abscesses | 1374 | ||
| Chapter Outline | 1374 | ||
| Bacterial Infections Involving or Affecting the Liver | 1374 | ||
| Gram-Positive and Gram-Negative Bacteria | 1374 | ||
| Toxic Shock Syndrome: Staphylococcus aureus or Group A Streptococci | 1374 | ||
| Clostridium perfringens | 1374 | ||
| Actinomyces | 1375 | ||
| Listeria | 1375 | ||
| Shigella and Salmonella | 1375 | ||
| Yersinia | 1375 | ||
| Gonococci | 1375 | ||
| Legionella | 1375 | ||
| Burkholderia pseudomallei (Melioidosis) | 1376 | ||
| Brucella | 1376 | ||
| Coxiella burnetii (Q Fever) | 1376 | ||
| Bartonella (Oroya Fever) | 1376 | ||
| Bacillary Angiomatosis and AIDS | 1376 | ||
| Bacterial Sepsis and Jaundice | 1376 | ||
| Chlamydia | 1376 | ||
| Fitz-Hugh–Curtis Syndrome | 1376 | ||
| Rickettsiae | 1376 | ||
| Rocky Mountain Spotted Fever | 1376 | ||
| Ehrlichiae | 1377 | ||
| Spirochetes | 1377 | ||
| Leptospirosis | 1377 | ||
| Syphilis | 1377 | ||
| Secondary Syphilis | 1377 | ||
| Tertiary (Late) Syphilis | 1377 | ||
| Lyme Disease | 1377 | ||
| TB and Other Mycobacteria | 1378 | ||
| Parasites (Tables 84-1 and 84-2) | 1378 | ||
| Protozoa (see also Chapter 113) | 1378 | ||
| Malaria | 1378 | ||
| The Plasmodium Life Cycle | 1378 | ||
| Histopathologic Features | 1378 |