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Book Details
Abstract
Well-organized and vibrantly illustrated throughout, Handbook of Liver Disease is a comprehensive yet concise handbook providing authoritative guidance on key clinical issues in liver disease. The quick-reference outline format ensures that you’ll find answers when you need them, and cover-to-cover updates keep you abreast of the recent rapid changes in the field. Written by leading international experts in hepatology, this reference is ideal for hepatologists, gastroenterologists, internists, family practitioners, trainees, and others who diagnose and manage patients with liver disorders.
- Uses a highly templated outline format, key points in each chapter, alert symbols, and highlighted review points to provide a "just the facts" approach to daily clinical questions on liver disease.
- Features expanded hepatitis chapters, including completely updated coverage of new, safe, and effective oral regimens for the treatment of hepatitis C.
- Provides completely updated coverage of: alcoholic liver disease * autoimmune hepatitis * portal hypertension * primary biliary cholangitis * hepatic tumors * cirrhosis * nonalcoholic liver disease * liver transplantation * and more.
- Includes the latest information on adolescents with liver disease moving into adult care.
- Covers the revised criteria for prioritizing liver transplantation using the MELDNa score, new options for the treatment of hepatocellular carcinoma, and improved management of hepatorenal syndrome.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| IFC | IFC | ||
| Handbook of Liver Disease | i | ||
| Handbook of Liver Disease | iii | ||
| Copyright | iv | ||
| Dedication | v | ||
| CONTRIBUTORS | vii | ||
| PREFACE | xiii | ||
| ACKNOWLEDGMENTS | xv | ||
| SPECIAL TRIBUTE | xvii | ||
| CONTENTS | xix | ||
| Handbook of Liver Disease | xxiii | ||
| FOREWORD | xxv | ||
| 1 - Assessment of Liver Function and Diagnostic Studies | 1 | ||
| Routine Liver Biochemical Tests | 1 | ||
| SERUM BILIRUBIN | 1 | ||
| SERUM AMINOTRANSFERASES (TABLE 1.1) | 3 | ||
| SERUM ALKALINE PHOSPHATASE | 5 | ||
| GAMMA-GLUTAMYLTRANSPEPTIDASE | 6 | ||
| 5’-NUCLEOTIDASE | 6 | ||
| LACTATE DEHYDROGENASE | 8 | ||
| SERUM PROTEINS | 8 | ||
| Assessment of Hepatic Metabolic Capacity | 9 | ||
| ANTIPYRINE CLEARANCE | 9 | ||
| AMINOPYRINE BREATH TEST | 9 | ||
| CAFFEINE CLEARANCE | 9 | ||
| GALACTOSE ELIMINATION CAPACITY | 10 | ||
| LIDOCAINE METABOLITE | 10 | ||
| Other Tests of Liver Function | 10 | ||
| SERUM BILE ACIDS | 10 | ||
| UREA SYNTHESIS | 11 | ||
| BROMSULPHALEIN | 11 | ||
| INDOCYANINE GREEN | 11 | ||
| NONINVASIVE SERUM MARKERS OF FIBROSIS | 11 | ||
| Direct Markers | 11 | ||
| Indirect Markers | 11 | ||
| Liver Biopsy | 11 | ||
| INDICATIONS | 12 | ||
| CONTRAINDICATIONS | 12 | ||
| TECHNIQUE | 13 | ||
| COMPLICATIONS | 13 | ||
| Hepatic Imaging | 13 | ||
| PLAIN ABDOMINAL X-RAY STUDIES AND BARIUM STUDIES | 14 | ||
| ULTRASONOGRAPHY | 14 | ||
| COMPUTED TOMOGRAPHY | 15 | ||
| MAGNETIC RESONANCE IMAGING | 15 | ||
| RADIOISOTOPE SCANNING | 16 | ||
| POSITRON EMISSION TOMOGRAPHY | 16 | ||
| ULTRASOUND ELASTOGRAPHY | 17 | ||
| FURTHER READING | 17 | ||
| 2 - Acute Liver Failure | 18 | ||
| Overview | 18 | ||
| Pathophysiology | 20 | ||
| Etiology | 20 | ||
| ACETAMINOPHEN HEPATOTOXICITY | 20 | ||
| IDIOSYNCRATIC DILI AND TOXIN EXPOSURE | 22 | ||
| Viral Hepatitis (see also Chapters 313970591406) | 23 | ||
| NONHEPATOTROPIC VIRUSES (SEE CHAPTER 6) | 24 | ||
| AUTOIMMUNE HEPATITIS (SEE CHAPTER 7) | 25 | ||
| VASCULAR OCCLUSION (SEE CHAPTER 21) | 25 | ||
| ISCHEMIC HEPATITIS (SEE CHAPTER 22) | 26 | ||
| WILSON DISEASE (SEE CHAPTER 19) | 26 | ||
| MALIGNANT INFILTRATION (SEE CHAPTER 24) | 27 | ||
| PREGNANCY-RELATED ALF (SEE CHAPTER 23) | 27 | ||
| ALF OF INDETERMINATE CAUSE | 27 | ||
| Treatment | 27 | ||
| INITIAL ASSESSMENT AND MANAGEMENT | 27 | ||
| EVALUATION FOR LT (SEE CHAPTER 33) | 30 | ||
| MANAGEMENT OF COMPLICATIONS | 30 | ||
| FUTURE THERAPIES | 32 | ||
| FURTHER READING | 33 | ||
| 3 - Hepatitis A and Hepatitis E | 34 | ||
| Hepatitis A Virus | 34 | ||
| MOLECULAR BIOLOGY | 34 | ||
| EPIDEMIOLOGY AND RISK FACTORS | 35 | ||
| PATHOPHYSIOLOGY | 37 | ||
| Cholestatic Hepatitis | 38 | ||
| Relapsing Hepatitis | 38 | ||
| EXTRAHEPATIC MANIFESTATIONS | 38 | ||
| 4 - Hepatitis B and Hepatitis D | 51 | ||
| Hepatitis B Virus | 51 | ||
| VIROLOGY | 51 | ||
| EPIDEMIOLOGY | 52 | ||
| Clinical Features | 53 | ||
| Laboratory Features | 54 | ||
| Acute HBV Infection and Liver Failure | 54 | ||
| Treatment | 55 | ||
| Clinical Features | 55 | ||
| Diagnosis | 56 | ||
| Treatment | 58 | ||
| Hepatitis B in Special Populations | 60 | ||
| PREGNANCY (FIG. 4.5) | 60 | ||
| REACTIVATION | 60 | ||
| PREVENTION | 60 | ||
| Hepatitis D Virus | 63 | ||
| VIROLOGY | 63 | ||
| PATHOGENESIS AND PATHOLOGY | 63 | ||
| CLINICAL FEATURES AND NATURAL HISTORY | 64 | ||
| SEROLOGIC AND VIROLOGIC TESTS | 64 | ||
| PREVENTION | 64 | ||
| TREATMENT | 65 | ||
| FURTHER READING | 65 | ||
| 5 - Hepatitis C | 66 | ||
| Overview | 66 | ||
| Virology | 66 | ||
| Epidemiology | 67 | ||
| Acute Hepatitis C | 67 | ||
| DIAGNOSIS (FIG. 5.1) | 67 | ||
| NATURAL HISTORY | 68 | ||
| TREATMENT AND PREVENTION | 68 | ||
| Chronic Hepatitis C | 69 | ||
| PATHOGENESIS AND PATHOLOGY | 69 | ||
| CLINICAL FEATURES AND NATURAL HISTORY | 69 | ||
| DIAGNOSIS | 70 | ||
| SCREENING AND COUNSELING | 71 | ||
| TREATMENT | 72 | ||
| FURTHER READING | 76 | ||
| 6 - Hepatitis Caused by Other Viruses | 78 | ||
| Overview | 78 | ||
| Viruses with Frequent Hepatic Involvement | 78 | ||
| CYTOMEGALOVIRUS | 78 | ||
| EPSTEIN-BARR VIRUS | 80 | ||
| Viruses with Less Frequent Hepatic Involvement | 80 | ||
| HERPES SIMPLEX VIRUS | 80 | ||
| OTHER VIRUSES | 81 | ||
| Viruses Uncommon in the Unites States but withFrequent Hepatic Involvement | 81 | ||
| VIRUSES OF UNCLEAR PATHOGENICITY | 82 | ||
| FURTHER READING | 82 | ||
| 7 - Autoimmune Hepatitis | 84 | ||
| Definition | 84 | ||
| NOMENCLATURE | 84 | ||
| Diagnosis | 84 | ||
| Pathogenesis | 86 | ||
| Classification | 88 | ||
| Epidemiology | 89 | ||
| Presentation (Table 7.4) | 89 | ||
| Clinical and Laboratory Features | 92 | ||
| HISTOLOGIC FEATURES | 93 | ||
| AUTOANTIBODIES | 94 | ||
| Treatment | 97 | ||
| REGIMENS | 97 | ||
| DRUG-RELATED SIDE EFFECTS | 98 | ||
| FACTORS THAT AFFECT INITIAL OUTCOME (TABLE 7.7) | 99 | ||
| TREATMENT OUTCOMES (TABLE 7.8) | 101 | ||
| MANAGEMENT AFTER REMISSION | 103 | ||
| Long-Term Outcomes | 107 | ||
| FURTHER READING | 108 | ||
| 8 - Alcoholic Liver Disease | 109 | ||
| Overview | 109 | ||
| DIAGNOSIS OF ALCOHOL DEPENDENCE AND ABUSE | 109 | ||
| SCREENING FOR ALCOHOL PROBLEMS | 110 | ||
| Alcohol Use Disorders Identification Test | 110 | ||
| Risk Factors for Alcoholic Liver Disease | 111 | ||
| SPECIFIC RISK FACTORS | 111 | ||
| Clinical Features | 112 | ||
| HISTORY | 112 | ||
| SYMPTOMS AND SIGNS | 113 | ||
| LABORATORY FEATURES (TABLE 8.2) | 113 | ||
| Diagnosis | 113 | ||
| Histology and Spectrum of Disease | 114 | ||
| FATTY LIVER (STEATOSIS) | 114 | ||
| ALCOHOLIC HEPATITIS | 114 | ||
| CIRRHOSIS | 114 | ||
| Indices of Liver Dysfunction for Alcoholic Hepatitis | 115 | ||
| Treatment | 117 | ||
| GENERAL MEASURES | 117 | ||
| SPECIFIC THERAPY FOR ALCOHOLIC HEPATITIS | 117 | ||
| SPECIFIC THERAPY FOR ALCOHOLIC CIRRHOSIS | 118 | ||
| FURTHER READING | 119 | ||
| 9 - Fatty Liver and Nonalcoholic Steatohepatitis | 121 | ||
| Overview | 121 | ||
| TERMINOLOGY | 121 | ||
| Pathogenesis | 122 | ||
| INCREASED PERIPHERAL MOBILIZATION OF FATTY ACIDS | 122 | ||
| INCREASED HEPATIC SYNTHESIS OF FATTY ACIDS | 122 | ||
| IMPAIRED HEPATIC CATABOLISM OF FATTY ACIDS | 122 | ||
| IMPAIRED SYNTHESIS OF TRIGLYCERIDE AND SECRETION AS VERY-LOW-DENSITY LIPOPROTEINS (VLDL) FROM THE LIVER | 122 | ||
| Clinical Features | 123 | ||
| SYMPTOMS | 123 | ||
| PHYSICAL FINDINGS | 123 | ||
| Risk Factors | 123 | ||
| Diagnosis | 125 | ||
| HISTORY | 125 | ||
| LABORATORY FEATURES | 126 | ||
| IMAGING | 126 | ||
| LIVER BIOPSY (SEE ALSO CHAPTER 1) | 127 | ||
| Prognosis (see Fig. 9.1) | 127 | ||
| STEATOSIS | 127 | ||
| NASH | 128 | ||
| Treatment | 128 | ||
| WEIGHT LOSS AND EXERCISE | 128 | ||
| MEDICATIONS | 128 | ||
| FURTHER READING | 128 | ||
| 10 - Drug-Induced and Toxic Liver Disease | 130 | ||
| Overview | 131 | ||
| Epidemiology | 132 | ||
| Biochemical, Clinical, and Pathologic Features | 135 | ||
| Clues to Drug-Induced Liver Injury | 146 | ||
| Prevention | 147 | ||
| Treatment (Box 10.4) | 152 | ||
| ACETAMINOPHEN POISONING | 152 | ||
| Treatment | 152 | ||
| MUSHROOM POISONING | 154 | ||
| ROLE OF NAC IN NONACETAMINOPHEN ALF | 155 | ||
| ROLE OF GLUCOCORTICOIDS | 155 | ||
| LEFLUNOMIDE TOXICITY | 155 | ||
| ANTI-TB DRUG HEPATOTOXICITY | 155 | ||
| LIVER ASSIST DEVICES (SEE CHAPTER 2) | 156 | ||
| REFERRAL TO A LIVER TRANSPLANT CENTER | 156 | ||
| FURTHER READING | 156 | ||
| 11 - Cirrhosis and Portal Hypertension | 158 | ||
| Cirrhosis | 158 | ||
| DEFINITION | 158 | ||
| CLASSIFICATION | 159 | ||
| PATHOLOGY | 159 | ||
| CLINICAL FEATURES | 160 | ||
| COMPLICATIONS | 163 | ||
| DIAGNOSIS | 163 | ||
| TREATMENT | 165 | ||
| PROGNOSIS | 165 | ||
| EVALUATION | 166 | ||
| Portal Hypertension | 166 | ||
| CLASSIFICATION (BOX 11.1) | 166 | ||
| CLINICAL CONSEQUENCES | 167 | ||
| MEASUREMENT OF PORTAL PRESSURE | 167 | ||
| TREATMENT OF COMPLICATIONS | 170 | ||
| EVALUATION | 170 | ||
| FURTHER READING | 171 | ||
| 12 - Portal Hypertension and Gastrointestinal Bleeding | 172 | ||
| Overview | 172 | ||
| PATHOPHYSIOLOGY | 172 | ||
| PHARMACOTHERAPY | 173 | ||
| EPIDEMIOLOGY OF ESOPHAGOGASTRIC VARICEAL HEMORRHAGE | 173 | ||
| RISK FACTORS FOR FIRST VARICEAL HEMORRHAGE | 174 | ||
| PREDICTIVE VALUE OF PORTAL HEMODYNAMIC MEASUREMENTS | 174 | ||
| Prevention of Initial Variceal Hemorrhage | 175 | ||
| PHARMACOLOGIC | 175 | ||
| ENDOSCOPIC | 175 | ||
| SURGICAL | 176 | ||
| Treatment of Acute Variceal Hemorrhage | 176 | ||
| INITIAL | 176 | ||
| ENDOSCOPIC | 176 | ||
| PHARMACOLOGIC | 177 | ||
| TIPS | 178 | ||
| BALLOON TAMPONADE | 178 | ||
| TREATMENT FOR FAILURES OF MEDICAL THERAPY | 178 | ||
| Prevention of Recurrent Variceal Hemorrhage | 178 | ||
| ENDOSCOPIC | 178 | ||
| PHARMACOLOGIC (TABLE 12.2) | 179 | ||
| COMBINED ENDOSCOPIC AND PHARMACOLOGIC | 179 | ||
| TREATMENT FOR FAILURES OF MEDICAL THERAPY | 179 | ||
| Management of Nonesophageal Variceal Sources of Bleeding Related to Portal Hypertension | 180 | ||
| GASTRIC VARICES | 180 | ||
| PORTAL HYPERTENSIVE GASTROPATHY | 180 | ||
| FURTHER READING | 180 | ||
| 13 - Ascites and Spontaneous Bacterial Peritonitis | 182 | ||
| Overview of Ascites | 182 | ||
| DEFINITION | 182 | ||
| EPIDEMIOLOGY | 182 | ||
| PATHOPHYSIOLOGY OF CIRRHOTIC ASCITES | 183 | ||
| Diagnosis | 183 | ||
| HISTORY | 183 | ||
| PHYSICAL EXAMINATION | 184 | ||
| LABORATORY AND IMAGING FEATURES | 184 | ||
| ASSESSMENT OF THE SEVERITY OF ASCITES | 185 | ||
| Ascitic Fluid Analysis | 185 | ||
| DIAGNOSTIC PARACENTESIS | 185 | ||
| ASCITES FLUID TESTS AND INTERPRETATION | 185 | ||
| Treatment of Cirrhotic Ascites | 187 | ||
| GENERAL PRINCIPLES | 187 | ||
| DIURETIC THERAPY | 188 | ||
| Definition and Diagnostic Criteria | 189 | ||
| Management | 189 | ||
| Spontaneous Bacterial Peritonitis and Other AsciticFluid Infections | 190 | ||
| OVERVIEW | 190 | ||
| PATHOGENESIS | 191 | ||
| CLINICAL FEATURES AND DIAGNOSIS | 191 | ||
| CLASSIFICATION (SEE TABLE 13.6) | 192 | ||
| TREATMENT | 193 | ||
| Prophylaxis of Ascitic Fluid Infection | 194 | ||
| INDICATIONS | 194 | ||
| ANTIBIOTIC REGIMENS | 194 | ||
| FUTURE CONSIDERATIONS | 195 | ||
| FUTHER READING | 195 | ||
| 14 - Hepatorenal Syndrome | 197 | ||
| Definition | 197 | ||
| Pathogenesis | 197 | ||
| VASOCONSTRICTOR FACTORS | 198 | ||
| VASODILATORY FACTORS | 200 | ||
| SUMMARY | 200 | ||
| Other Causes of Acute Kidney Injury in Cirrhosis | 201 | ||
| ACUTE TUBULAR NECROSIS | 201 | ||
| GLOMERULAR DISEASE | 201 | ||
| DRUG-INDUCED KIDNEY INJURY | 201 | ||
| PRERENAL AZOTEMIA | 202 | ||
| TYPE 1 | 202 | ||
| TYPE 2 | 202 | ||
| Treatment | 202 | ||
| TYPE 1 HEPATORENAL SYNDROME (FIG. 14.2) | 203 | ||
| TYPE 2 HEPATORENAL SYNDROME | 205 | ||
| Prevention | 205 | ||
| 15 - Hepatic Encephalopathy | 207 | ||
| Definition and Classification | 207 | ||
| Pathophysiology | 207 | ||
| Clinical Features | 208 | ||
| Diagnosis | 209 | ||
| COVERT HEPATIC ENCEPHALOPATHY | 210 | ||
| Overt Hepatic Encephalopathy | 210 | ||
| Laboratory Tests | 211 | ||
| Treatment | 213 | ||
| FURTHER READING | 215 | ||
| 16 - Primary Biliary Cholangitis | 217 | ||
| Nomenclature | 217 | ||
| Epidemiology | 218 | ||
| Genetics | 218 | ||
| Immunology | 218 | ||
| Pathogenesis | 220 | ||
| Pathology | 220 | ||
| GROSS FINDINGS | 220 | ||
| HISTOLOGIC FINDINGS | 221 | ||
| Clinical Features | 224 | ||
| SYMPTOMS | 224 | ||
| PHYSICAL EXAMINATION | 225 | ||
| Diagnosis | 225 | ||
| LABORATORY TESTS | 225 | ||
| LIVER BIOPSY | 226 | ||
| IMAGING TESTS | 227 | ||
| PRINCIPLES OF DIAGNOSIS | 227 | ||
| DIFFERENTIAL DIAGNOSIS | 227 | ||
| Natural History and Prognosis | 227 | ||
| Treatment | 228 | ||
| SYMPTOMS OF CHRONIC CHOLESTASIS | 228 | ||
| UNDERLYING DISEASE (TABLE 16.2) | 229 | ||
| SURVEILLANCE FOR COMPLICATIONS OF CIRRHOSIS | 231 | ||
| Risk Stratification | 231 | ||
| Liver Transplantation | 232 | ||
| FURTHER READING | 232 | ||
| 17 - Primary Sclerosing Cholangitis | 233 | ||
| Overview | 233 | ||
| Terminology and Diagnostic Criteria | 233 | ||
| Epidemiology | 235 | ||
| Etiology and Pathogenesis | 235 | ||
| Clinical Features | 236 | ||
| Diseases Associated With Primary Sclerosing Cholangitis | 236 | ||
| Natural History | 238 | ||
| Treatment | 240 | ||
| Complications and Their Treatment | 241 | ||
| Acknowledgment | 242 | ||
| FURTHER READING | 242 | ||
| 18 - Hemochromatosis | 243 | ||
| Epidemiology and Genetics | 243 | ||
| Classification | 243 | ||
| HFE HEMOCHROMATOSIS (TYPE 1) | 243 | ||
| NON-HFE HEMOCHROMATOSIS | 244 | ||
| Pathophysiology | 245 | ||
| IRON ABSORPTION | 245 | ||
| PARENCHYMAL IRON DEPOSITION IN TYPES 1 TO 3 HEREDITARY HEMOCHROMATOSIS | 245 | ||
| EFFECT OF ALCOHOL INTAKE | 245 | ||
| EFFECT OF NONALCOHOLIC FATTY LIVER DISEASE | 246 | ||
| LIVER DAMAGE | 246 | ||
| Clinical Features | 246 | ||
| LIVER DISEASE | 247 | ||
| CARDIAC DISEASE | 247 | ||
| DIABETES MELLITUS | 247 | ||
| JOINT DISEASE | 247 | ||
| INFECTIONS | 247 | ||
| Natural History and Prognosis | 248 | ||
| Diagnosis | 248 | ||
| CLINICAL SUSPICION AND LABORATORY TESTS | 248 | ||
| GENOTYPING | 249 | ||
| LIVER BIOPSY | 250 | ||
| OTHER TESTS | 250 | ||
| Differential Diagnosis | 250 | ||
| Treatment | 251 | ||
| Screening | 252 | ||
| FAMILY SCREENING | 252 | ||
| POPULATION SCREENING | 252 | ||
| FURTHER READING | 252 | ||
| 19 - Wilson Disease and Related Disorders | 253 | ||
| Copper Metabolism (Figs. 19.1 and 19.2) | 253 | ||
| Genetics | 254 | ||
| Pathogenesis | 256 | ||
| Clinical Features | 256 | ||
| HEPATIC | 256 | ||
| Acute Liver Failure | 257 | ||
| NEUROLOGIC | 257 | ||
| PSYCHIATRIC | 257 | ||
| Sunflower Cataracts | 258 | ||
| RENAL | 258 | ||
| SKELETAL | 258 | ||
| OTHERS | 259 | ||
| Diagnosis | 259 | ||
| TESTS | 259 | ||
| SCORING SYSTEMS | 261 | ||
| DIAGNOSTIC APPROACH | 261 | ||
| Treatment | 261 | ||
| DIET | 261 | ||
| DRUGS | 263 | ||
| PREFERRED REGIMENS | 265 | ||
| LIVER TRANSPLANTATION (SEE ALSO CHAPTER 33) | 266 | ||
| FUTURE THERAPIES | 267 | ||
| Other Copper-Related Disorders | 267 | ||
| INDIAN CHILDHOOD CIRRHOSIS | 267 | ||
| IDIOPATHIC COPPER TOXICOSIS | 267 | ||
| MENKES DISEASE | 268 | ||
| FURTHER READING | 268 | ||
| 20 - Alpha-1 Antitrypsin Deficiency and Other Metabolic Liver Diseases | 269 | ||
| Overview | 269 | ||
| Alpha-1 Antitrypsin Deficiency | 270 | ||
| GENETICS | 270 | ||
| CLINICAL FEATURES | 270 | ||
| PATHOGENESIS | 271 | ||
| DIAGNOSIS | 271 | ||
| TREATMENT AND SCREENING | 272 | ||
| Hereditary Tyrosinemia | 272 | ||
| GENETICS | 272 | ||
| CLINICAL FEATURES | 272 | ||
| PATHOGENESIS | 273 | ||
| DIAGNOSIS | 273 | ||
| TREATMENT AND SCREENING | 273 | ||
| Gaucher Disease | 274 | ||
| GENETICS | 274 | ||
| CLINICAL FEATURES | 274 | ||
| DIAGNOSIS | 274 | ||
| TREATMENT AND SCREENING | 274 | ||
| Glycogen Storage Disease | 275 | ||
| GENETICS | 275 | ||
| CLINICAL FEATURES | 275 | ||
| PATHOGENESIS AND DIAGNOSIS | 276 | ||
| TREATMENT AND SCREENING | 276 | ||
| Cystic Fibrosis | 276 | ||
| GENETICS | 276 | ||
| CLINICAL FEATURES | 277 | ||
| PATHOGENESIS AND DIAGNOSIS | 277 | ||
| TREATMENT AND SCREENING | 277 | ||
| Porphyria | 278 | ||
| GENETICS | 278 | ||
| CLINICAL FEATURES | 278 | ||
| PATHOGENESIS AND DIAGNOSIS | 279 | ||
| TREATMENT AND SCREENING | 279 | ||
| Other Inborn Errors of Metabolism | 280 | ||
| HYPERAMMONEMIC SYNDROMES | 280 | ||
| DISORDERS THAT CAUSE DAMAGE TO OTHER ORGANS | 280 | ||
| FURTHER READING | 281 | ||
| 21 - Budd-Chiari Syndrome and Other Vascular Disorders | 282 | ||
| Budd-Chiari Syndrome | 282 | ||
| CLASSIFICATION AND ETIOLOGY | 282 | ||
| CLINICAL AND LABORATORY FEATURES | 284 | ||
| DIAGNOSIS | 284 | ||
| TREATMENT | 285 | ||
| Portal Venous Thrombosis | 287 | ||
| CLASSIFICATION | 287 | ||
| ETIOLOGY | 287 | ||
| CLINICAL FEATURES | 288 | ||
| DIAGNOSIS | 288 | ||
| TREATMENT | 289 | ||
| Sinusoidal Obstruction Syndrome | 290 | ||
| DEFINITION AND ETIOLOGY | 290 | ||
| RISK FACTORS FOR ACUTE SOS FOLLOWING HSCT | 290 | ||
| PATHOGENESIS | 290 | ||
| CLINICAL FEATURES AND DIAGNOSIS | 291 | ||
| TREATMENT | 291 | ||
| FURTHER READING | 292 | ||
| 22 - The Liver in Heart Failure | 293 | ||
| Overview | 293 | ||
| Hepatic Circulation | 294 | ||
| HEPATIC BLOOD SUPPLY | 294 | ||
| HEPATIC VENOUS DRAINAGE | 294 | ||
| HEPATIC MICROCIRCULATION | 294 | ||
| Liver Histology | 294 | ||
| Pathophysiology | 295 | ||
| CHRONIC PASSIVE CONGESTION | 295 | ||
| DECREASED HEPATIC BLOOD FLOW | 295 | ||
| Pathology | 296 | ||
| MACROSCOPIC | 296 | ||
| MICROSCOPIC | 297 | ||
| Epidemiology | 299 | ||
| Etiology (Table 22.1) | 299 | ||
| CHRONIC CONGESTION | 299 | ||
| ACUTE HYPOXIC HEPATITIS | 300 | ||
| CONDITIONS THAT AFFECT BOTH THE HEART AND THE LIVER | 300 | ||
| Clinical Features | 300 | ||
| CONGESTIVE HEPATOPATHY | 300 | ||
| HYPOXIC HEPATITIS | 301 | ||
| CARDIAC CIRRHOSIS | 302 | ||
| Laboratory Features | 302 | ||
| CONGESTIVE HEPATOPATHY | 302 | ||
| HYPOXIC HEPATITIS | 303 | ||
| CARDIAC CIRRHOSIS | 304 | ||
| LIVER DYSFUNCTION WITH THE USE OF A LEFT VENTRICULARASSIST DEVICE | 304 | ||
| Imaging Features | 304 | ||
| DOPPLER ULTRASONOGRAPHY | 304 | ||
| CONTRAST-ENHANCED COMPUTED TOMOGRAPHY | 304 | ||
| MAGNETIC RESONANCE IMAGING | 304 | ||
| ULTRASOUND ELASTOGRAPHY | 305 | ||
| Treatment | 305 | ||
| GENERAL MEASURES | 305 | ||
| DRUG TREATMENT OF HEART FAILURE WITH LIVER DYSFUNCTION | 305 | ||
| CARDIAC SURGERY | 306 | ||
| CARDIAC TRANSPLANTATION | 306 | ||
| Prognosis | 307 | ||
| FURTHER READING | 307 | ||
| 23 - The Liver in Pregnancy | 308 | ||
| Overview | 308 | ||
| Approach to the Pregnant Patient | 309 | ||
| HISTORY | 309 | ||
| PHYSICAL EXAMINATION | 310 | ||
| DIAGNOSTIC TESTS | 311 | ||
| Liver Disorders Unique to Pregnancy | 311 | ||
| HYPEREMESIS GRAVIDARUM | 311 | ||
| Intrahepatic Cholestasis of Pregnancy | 313 | ||
| ACUTE FATTY LIVER OF PREGNANCY | 313 | ||
| PREECLAMPSIA/ECLAMPSIA | 315 | ||
| HELLP SYNDROME | 316 | ||
| HEPATIC RUPTURE | 317 | ||
| Pregnancy in Patients With Chronic Liver Disease | 317 | ||
| OVERVIEW | 317 | ||
| Cirrhosis (see also Chapters 11 and 12) | 317 | ||
| WILSON DISEASE (SEE ALSO CHAPTER 19) | 318 | ||
| AUTOIMMUNE HEPATITIS (SEE ALSO CHAPTER 7) | 318 | ||
| PRIMARY BILIARY CHOLANGITIS (SEE ALSO CHAPTER 16) | 319 | ||
| PRIMARY SCLEROSING CHOLANGITIS (SEE ALSO CHAPTER 17) | 319 | ||
| NONALCOHOLIC FATTY LIVER DISEASE (SEE ALSO CHAPTER 9) | 319 | ||
| Viral Hepatitis and Herpes Simplex Virus Infections in Pregnant Women (see also Chapters 313970591406) | 319 | ||
| OVERVIEW | 319 | ||
| HEPATITIS A (SEE ALSO CHAPTER 3) | 319 | ||
| HEPATITIS B (SEE ALSO CHAPTER 4) | 320 | ||
| HEPATITIS C (SEE ALSO CHAPTER 5) | 320 | ||
| HEPATITIS D (SEE ALSO CHAPTER 4) | 321 | ||
| HEPATITIS E (SEE ALSO CHAPTER 3) | 321 | ||
| HERPES SIMPLEX VIRUS INFECTIONS (SEE CHAPTER 6) | 321 | ||
| Budd-Chiari Syndrome (see also Chapter 21) | 321 | ||
| Cholelithiasis and Cholecystitis in Pregnant Women (see also Chapter 34) | 322 | ||
| FURTHER READING | 322 | ||
| 24 - The Liver in Systemic Disease | 324 | ||
| Cardiac Disease (see Chapter 22) | 324 | ||
| HEART FAILURE | 324 | ||
| ISCHEMIC HEPATITIS AND LEFT-SIDED HEART FAILURE | 326 | ||
| Systemic Autoimmune Diseases | 326 | ||
| IMMUNOGLOBULIN G4-RELATED DISEASE | 326 | ||
| POLYMYALGIA RHEUMATICA AND GIANT CELL ARTERITIS | 327 | ||
| RHEUMATOID ARTHRITIS | 327 | ||
| ADULT STILL DISEASE | 327 | ||
| SYSTEMIC LUPUS ERYTHEMATOSUS | 327 | ||
| SJÖGREN SYNDROME | 328 | ||
| OTHER CAUSES OF VASCULITIS | 328 | ||
| Endocrine and Metabolic Disorders | 328 | ||
| HYPERTHYROIDISM | 328 | ||
| TYPE 2 DIABETES MELLITUS AND THE METABOLIC SYNDROME | 328 | ||
| Granulomatous Disease and Sarcoidosis (see Chapter 28) | 329 | ||
| Lymphoma and Hematologic Diseases | 329 | ||
| LYMPHOMA | 329 | ||
| MALIGNANT HEMATOLOGIC CONDITIONS | 329 | ||
| SICKLE CELL DISEASE | 330 | ||
| Infections (see Chapter 31) | 330 | ||
| SYSTEMIC INFECTION, SEPSIS, AND THE CRITICALLY ILL PATIENT | 330 | ||
| HUMAN IMMUNODEFICIENCY VIRUS INFECTION (SEE CHAPTER 27) | 331 | ||
| Tuberculosis (see Chapters 28 and 31) | 331 | ||
| Gastrointestinal and Nutritional Disorders | 331 | ||
| CELIAC DISEASE | 331 | ||
| INFLAMMATORY BOWEL DISEASE | 331 | ||
| OBESITY | 332 | ||
| ANOREXIA NERVOSA | 333 | ||
| Amyloidosis | 333 | ||
| FURTHER READING | 333 | ||
| 25 - Pediatric Liver Disease | 335 | ||
| Consequences of Physiologic Immaturity of the Liver | 335 | ||
| Hyperbilirubinemia | 336 | ||
| PATHOPHYSIOLOGY | 336 | ||
| COMPLICATIONS | 340 | ||
| TREATMENT | 340 | ||
| Liver Failure (see Chapter 2) | 341 | ||
| GALACTOSEMIA | 341 | ||
| PRIMARY MITOCHONDRIAL HEPATOPATHIES | 342 | ||
| GESTATIONAL ALLOIMMUNE LIVER DISEASE | 343 | ||
| CITRIN DEFICIENCY | 343 | ||
| REYE SYNDROME | 344 | ||
| Hepatomegaly | 344 | ||
| FIBROSIS | 344 | ||
| VENOUS CONGESTION | 344 | ||
| ACCUMULATION OF METABOLIC SUBSTANCES | 345 | ||
| TUMOR INFILTRATION | 347 | ||
| Viral Hepatitis (see Chapters 3 to 5) | 347 | ||
| Systemic Conditions Affecting the Liver (see Chapter 24) | 348 | ||
| FURTHER READING | 350 | ||
| 26 - Liver Disease in the Elderly | 351 | ||
| Cellular and Biochemical Aspects | 351 | ||
| OVERVIEW | 351 | ||
| CELLULAR AND BIOCHEMICAL CHANGES IN THE AGING LIVER | 351 | ||
| Pathophysiology of the Aging Liver | 352 | ||
| OVERVIEW | 352 | ||
| CHANGES IN DRUG METABOLISM | 352 | ||
| ALTERATIONS IN CHOLESTEROL METABOLISM | 353 | ||
| Hepatic Diseases in Older Adults | 353 | ||
| Acute Viral Hepatitis (see Chapters 313970591406) | 353 | ||
| Chronic Viral Hepatitis (see Chapters 4 and 5) | 354 | ||
| DRUG-INDUCED LIVER INJURY (SEE CHAPTER 10) | 355 | ||
| AUTOIMMUNE LIVER DISEASES | 356 | ||
| ALCOHOLIC LIVER DISEASE (SEE CHAPTER 8) | 356 | ||
| METABOLIC LIVER DISEASES | 357 | ||
| LIVER ABSCESS (SEE CHAPTER 30) | 357 | ||
| GALLSTONES AND BILIARY DISEASE (SEE CHAPTER 34) | 358 | ||
| HEPATIC TUMORS (SEE CHAPTER 29) | 358 | ||
| ACUTE LIVER FAILURE (SEE CHAPTER 2) | 359 | ||
| PORTAL HYPERTENSION (SEE CHAPTER 12) | 360 | ||
| LIVER TRANSPLANTATION (SEE CHAPTER 33) | 360 | ||
| FURTHER READING | 361 | ||
| 27 - Hepatobiliary Complications of HIV | 362 | ||
| Viral Hepatitis and Other Viral Infections | 363 | ||
| HEPATITIS A VIRUS (SEE CHAPTER 3) | 363 | ||
| HEPATITIS B AND D VIRUSES (SEE CHAPTER 4) | 363 | ||
| HEPATITIS C VIRUS (SEE CHAPTER 5) | 364 | ||
| Other Viruses (see Chapters 3 and 6) | 365 | ||
| Other Infections (see also Chapter 31 and Box 27.2) | 365 | ||
| DISSEMINATED MYCOBACTERIUM AVIUM COMPLEX INFECTION | 365 | ||
| PELIOSIS HEPATIS | 366 | ||
| FUNGAL AND PROTOZOAL INFECTIONS | 367 | ||
| Malignant Diseases | 367 | ||
| LYMPHOMA (SEE ALSO CHAPTER 24) | 367 | ||
| KAPOSI SARCOMA | 367 | ||
| HEPATOCELLULAR CARCINOMA (SEE ALSO CHAPTER 29) | 367 | ||
| Nonalcoholic Fatty Liver Disease (see Chapter 9) | 367 | ||
| Antiretroviral-Induced Hepatotoxicity | 368 | ||
| AIDS-Related Biliary Tract Diseases | 368 | ||
| AIDS CHOLANGIOPATHY | 368 | ||
| ACALCULOUS CHOLECYSTITIS | 370 | ||
| NONCIRRHOTIC PORTAL HYPERTENSION | 370 | ||
| FURTHER READING | 370 | ||
| 28 - Granulomatous Liver Disease | 372 | ||
| Overview of Granulomas | 372 | ||
| DEFINITION AND PATHOGENESIS | 372 | ||
| MORPHOLOGIC TYPES | 373 | ||
| INCIDENCE AND LOCATION | 373 | ||
| Causes of Hepatic Granulomas | 373 | ||
| Clinical and Biochemical Features | 373 | ||
| SYMPTOMS AND SIGNS | 373 | ||
| LIVER BIOCHEMICAL FEATURES | 374 | ||
| OTHER LABORATORY FEATURES | 375 | ||
| Specific Types of Granulomatous Liver Disease | 375 | ||
| SARCOIDOSIS (SEE ALSO CHAPTER 24) | 375 | ||
| TUBERCULOSIS (SEE ALSO CHAPTER 31) | 376 | ||
| SCHISTOSOMIASIS (SEE ALSO CHAPTER 31) | 377 | ||
| ACQUIRED IMMUNODEFICIENCY SYNDROME (SEE ALSO CHAPTER 27) | 377 | ||
| PRIMARY BILIARY CHOLANGITIS (SEE ALSO CHAPTER 16) | 378 | ||
| LIPOGRANULOMAS | 378 | ||
| FIBRIN-RING (“DOUGHNUT”) GRANULOMAS | 378 | ||
| DRUG-RELATED GRANULOMAS | 380 | ||
| MISCELLANEOUS CONDITIONS | 380 | ||
| Therapy | 380 | ||
| FURTHER READING | 381 | ||
| 29 - Hepatic Tumors | 383 | ||
| Benign Tumors of the Liver | 383 | ||
| HEPATIC ADENOMA | 383 | ||
| TUMORLIKE LESIONS OF HEPATOCYTES | 384 | ||
| HEMANGIOMA | 385 | ||
| BENIGN HEPATIC TUMORS OF CHOLANGIOCELLULAR ORIGIN | 385 | ||
| BENIGN HEPATIC TUMORS OF MESENCHYMAL ORIGIN | 386 | ||
| Malignant Tumors of the Liver | 386 | ||
| METASTATIC DISEASE | 386 | ||
| HEPATOCELLULAR CARCINOMA | 386 | ||
| CHOLANGIOCARCINOMA (SEE ALSO CHAPTER 36) | 390 | ||
| PEDIATRIC TUMORS OF THE LIVER (SEE ALSO CHAPTER 25) | 391 | ||
| OTHER TUMORS OF THE LIVER | 392 | ||
| Diagnostic Approach to Liver Masses or Tumors | 393 | ||
| FURTHER READING | 393 | ||
| 30 - Hepatic Abscesses and Cysts | 395 | ||
| Amebic Liver Abscess | 395 | ||
| OVERVIEW | 395 | ||
| PARASITOLOGY | 395 | ||
| EPIDEMIOLOGY | 396 | ||
| PATHOGENESIS | 396 | ||
| CLINICAL FEATURES | 397 | ||
| DIAGNOSIS | 397 | ||
| COMPLICATIONS | 398 | ||
| TREATMENT AND PROGNOSIS | 399 | ||
| Pyogenic Liver Abscess | 400 | ||
| OVERVIEW | 400 | ||
| MICROBIOLOGY | 400 | ||
| EPIDEMIOLOGY | 401 | ||
| PATHOGENESIS | 402 | ||
| CLINICAL FEATURES | 402 | ||
| DIAGNOSIS | 402 | ||
| COMPLICATIONS | 404 | ||
| TREATMENT | 404 | ||
| PROGNOSIS | 404 | ||
| Hepatic Cysts | 405 | ||
| 31 - Other Infections Involving the Liver | 413 | ||
| Bacterial Infections Involving the Liver | 413 | ||
| LEGIONELLA PNEUMOPHILA | 413 | ||
| CLOSTRIDIUM PERFRINGENS | 414 | ||
| LISTERIA MONOCYTOGENES | 414 | ||
| NEISSERIA GONORRHOEAE | 414 | ||
| SHIGELLA AND SALMONELLA SPECIES | 415 | ||
| YERSINIA ENTEROCOLITICA | 415 | ||
| COXIELLA BURNETII (Q FEVER) | 415 | ||
| Spirochetal Infections of the Liver | 417 | ||
| LEPTOSPIRA SPECIES (LEPTOSPIROSIS) | 417 | ||
| TREPONEMA PALLIDUM (SYPHILIS) | 417 | ||
| BORRELIA BURGDORFERI (LYME DISEASE) | 418 | ||
| Parasitic Diseases that Involve the Liver (Table 31.1) | 418 | ||
| PROTOZOAL INFECTIONS | 418 | ||
| Fungal Liver Disease | 434 | ||
| CANDIDIASIS | 434 | ||
| HISTOPLASMOSIS | 435 | ||
| Acknowledgment | 435 | ||
| FURTHER READING | 436 | ||
| 32 - Surgery in the Patient With Liver Disease and Postoperative Jaundice | 437 | ||
| Effects of Anesthesia and Surgery on the Liver | 437 | ||
| OVERVIEW | 437 | ||
| EFFECTS OF ANESTHETIC AGENTS ON THE CIRRHOTIC LIVER | 437 | ||
| OTHER INTRAOPERATIVE FACTORS | 438 | ||
| HEPATIC METABOLISM OF ANESTHETIC AGENTS | 438 | ||
| OTHER AGENTS IN LIVER DISEASE | 438 | ||
| EFFECT OF SURGERY | 439 | ||
| PROBLEMS IN ESTIMATING OPERATIVE RISK | 440 | ||
| Acute Hepatitis (see Chapters 3, 4, and 5) | 440 | ||
| Chronic Hepatitis (see Chapters 4 and 5) | 440 | ||
| CIRRHOSIS (SEE CHAPTER 11) | 441 | ||
| Use of the Child-Pugh Classification to Assess Surgical Risk (Table 32.1) | 441 | ||
| Use of the MELD Score to Assess Surgical Risk | 443 | ||
| Obstructive Jaundice (see Chapters 35 and 36) | 444 | ||
| SURGICAL RISK | 444 | ||
| STRATEGIES TO REDUCE POTENTIAL COMPLICATIONS | 445 | ||
| PREOPERATIVE BILIARY DECOMPRESSION | 445 | ||
| Hepatic Resection (see Chapter 29) | 446 | ||
| Preoperative Evaluation and Preparation | 446 | ||
| GENERAL MEASURES | 446 | ||
| TREATMENT OF COAGULOPATHY | 447 | ||
| TREATMENT OF ASCITES (SEE CHAPTER 13) | 447 | ||
| TREATMENT OF RENAL DYSFUNCTION (SEE CHAPTER 14) | 448 | ||
| TREATMENT OF HEPATIC ENCEPHALOPATHY (SEE CHAPTER 15) | 448 | ||
| MISCELLANEOUS ISSUES | 449 | ||
| Postoperative Jaundice | 449 | ||
| FURTHER READING | 451 | ||
| 33 - Liver Transplantation | 452 | ||
| Overview | 452 | ||
| Indications | 453 | ||
| Cirrhosis and Esld (see also Chapters 11 through 15) | 454 | ||
| ACUTE LIVER FAILURE (SEE ALSO CHAPTER 2) | 454 | ||
| PRIMARY HEPATIC MALIGNANT TUMORS (SEE ALSO CHAPTER 29) | 454 | ||
| METABOLIC DISORDERS | 457 | ||
| Contraindications | 458 | ||
| Comorbid Conditions That Influence Selection | 458 | ||
| CARDIOVASCULAR DISEASE | 458 | ||
| PULMONARY DISEASE | 459 | ||
| INFECTION | 459 | ||
| RENAL DYSFUNCTION | 460 | ||
| SUBSTANCE ABUSE AND BEHAVIORAL DISORDERS | 460 | ||
| NONHEPATIC MALIGNANCIES | 461 | ||
| Evaluation and Listing | 461 | ||
| MELD EXCEPTIONS | 462 | ||
| Surgical Aspects | 462 | ||
| APPROACHES TO EXPANDING THE DONOR ORGAN SUPPLY | 463 | ||
| Immunosuppression | 463 | ||
| GLUCOCORTICOIDS | 464 | ||
| MYCOPHENOLATE MOFETIL AND MYCOPHENOLIC ACID | 464 | ||
| ANTIBODY THERAPY | 465 | ||
| Complications | 466 | ||
| PRIMARY GRAFT NONFUNCTION | 466 | ||
| HYPERACUTE REJECTION | 466 | ||
| ACUTE CELLULAR REJECTION | 466 | ||
| CHRONIC REJECTION | 466 | ||
| ANTIBODY-MEDIATED REJECTION | 466 | ||
| VASCULAR COMPLICATIONS | 467 | ||
| BILIARY COMPLICATIONS | 467 | ||
| INFECTIONS | 467 | ||
| Long-Term Care of Liver Transplant Recipients | 468 | ||
| FURTHER READING | 469 | ||
| 34 - Cholelithiasis and Cholecystitis | 470 | ||
| Cholelithiasis (Gallstones) | 470 | ||
| TYPES OF GALLSTONES | 470 | ||
| DIAGNOSIS | 471 | ||
| COMMON CONSEQUENCES (SEE ALSO CHAPTER 35) | 473 | ||
| TREATMENT | 473 | ||
| Acute Cholecystitis | 474 | ||
| ACUTE CALCULOUS CHOLECYSTITIS | 474 | ||
| ACUTE ACALCULOUS CHOLECYSTITIS | 474 | ||
| CLINICAL FEATURES | 474 | ||
| DIAGNOSIS | 475 | ||
| TREATMENT | 475 | ||
| Emphysematous Cholecystitis | 477 | ||
| Uncommon Consequences of Gallstones | 477 | ||
| MIRIZZI SYNDROME | 477 | ||
| CHOLECYSTOENTERIC FISTULA | 478 | ||
| FURTHER READING | 478 | ||
| 35 - Diseases of the Bile Ducts | 479 | ||
| Bile Duct Stones | 480 | ||
| RISK FACTORS | 480 | ||
| CLINICAL FEATURES | 480 | ||
| LABORATORY FEATURES | 481 | ||
| IMAGING STUDIES | 481 | ||
| TREATMENT | 483 | ||
| Gallstone Pancreatitis | 485 | ||
| CLINICAL FEATURES | 485 | ||
| LABORATORY FEATURES | 485 | ||
| TREATMENT | 486 | ||
| Postcholecystectomy Syndrome | 486 | ||
| DEFINITION | 486 | ||
| DIFFERENTIAL DIAGNOSIS | 487 | ||
| SPHINCTER OF ODDI DYSFUNCTION | 487 | ||
| Postoperative Bile Duct Injuries and Leaks | 488 | ||
| OVERVIEW | 488 | ||
| CLASSIFICATION | 488 | ||
| CAUSES | 488 | ||
| DIAGNOSIS | 488 | ||
| TREATMENT | 489 | ||
| Recurrent Pyogenic Cholangitis | 489 | ||
| OVERVIEW | 489 | ||
| PATHOGENESIS | 490 | ||
| CLINICAL AND LABORATORY FEATURES | 490 | ||
| DIAGNOSIS | 490 | ||
| TREATMENT | 491 | ||
| Biliary Cysts | 491 | ||
| OVERVIEW | 491 | ||
| PATHOGENESIS | 492 | ||
| Classification by Todani et al (1977) (Fig. 35.6) | 493 | ||
| CLINICAL FEATURES | 493 | ||
| DIAGNOSIS | 493 | ||
| COMPLICATIONS | 494 | ||
| TREATMENT | 494 | ||
| Premalignant Lesions of the Bile Duct (see Chapter 36) | 494 | ||
| DIAGNOSIS | 495 | ||
| TREATMENT | 496 | ||
| Bile Duct Strictures | 496 | ||
| FURTHER READING | 498 | ||
| 36 - Tumors of the Biliary Tract | 499 | ||
| Benign Tumors of the Gallbladder | 499 | ||
| PSEUDOPOLYPS (CHOLESTEROL POLYPS) | 499 | ||
| ADENOMYOMATOSIS | 499 | ||
| ADENOMAS | 500 | ||
| TREATMENT | 500 | ||
| Benign Tumors of the Bile Duct (see also Chapter 35) | 500 | ||
| Carcinoma of the Gallbladder | 500 | ||
| EPIDEMIOLOGY | 500 | ||
| RISK FACTORS (BOX 36.1) | 501 | ||
| PATHOLOGY | 502 | ||
| CLINICAL FEATURES | 502 | ||
| DIAGNOSIS | 503 | ||
| STAGING | 503 | ||
| TREATMENT | 504 | ||
| PROGNOSIS | 505 | ||
| Carcinoma of the Bile Duct (Cholangiocarcinoma) | 506 | ||
| THREE TYPES (TABLE 36.3) | 506 | ||
| EPIDEMIOLOGY | 506 | ||
| RISK FACTORS (TABLE 36.4) | 506 | ||
| PATHOLOGY | 508 | ||
| CLINICAL FEATURES | 508 | ||
| DIAGNOSIS | 509 | ||
| STAGING | 510 | ||
| TREATMENT | 510 | ||
| PROGNOSIS | 511 | ||
| FURTHER READING | 512 | ||
| INDEX | 513 | ||
| A | 513 | ||
| B | 517 | ||
| C | 519 | ||
| D | 522 | ||
| E | 523 | ||
| F | 524 | ||
| G | 524 | ||
| H | 526 | ||
| I | 531 | ||
| J | 533 | ||
| K | 533 | ||
| L | 533 | ||
| M | 534 | ||
| N | 536 | ||
| O | 537 | ||
| P | 538 | ||
| Q | 541 | ||
| R | 541 | ||
| S | 542 | ||
| T | 544 | ||
| U | 545 | ||
| V | 545 | ||
| W | 546 | ||
| X | 547 | ||
| Y | 547 | ||
| Z | 547 |