Hepatology: Clinical Cases Uncovered (eBook)

Kathryn Nash is a Consultant Hepatologist at Southampton General Hospital Indra Neil Guha is Clinical Associate Professor in Hepatology at University of Nottingham

Preface, vii

Acknowledgements, viii

How to use this book, ix

Normal values, x

List of abbreviations, xi

Part 1 Basics, 1

Basic science, 1

Approach to the patient, 20

Part 2 Cases, 39

Patients with acute liver disease

Case 1 A 19-year-old man presenting with jaundice, 39

Case 2 A 25-year-old man with nausea, vomiting and
jaundice, 42

Case 3 A 45-year-old woman presenting with severe right
upper quadrant pain and jaundice, 46

Case 4 A 72-year-old man with painless jaundice, 52

Case 5 A 23-year-old woman with vomiting and epigastric
pain, 57

Case 6 A 4-week-old baby with jaundice and failure to
thrive, 63

Case 7 A 24-year-old woman with HIV and tuberculosis
develops jaundice, 68

Case 8 Abnormal liver function tests in a collapsed
patient, 71

Case 9 Abnormal liver function tests in a pregnant woman,
74

Case 10 A 27-year-old woman with abdominal pain and
distension, 77

Patients with chronic liver disease

Case 11 A 40-year-old woman with lethargy and pruritus,
81

Case 12 A 25-year-old woman with malaise and elevated
liver enzymes, 87

Case 13 Deranged liver function tests in a patient with
ulcerative colitis, 90

Case 14 Fatigue and deranged liver function tests in a
patient with haemophilia, 94

Case 15 A 34-year-old man from Hong Kong with jaundice
and vomiting, 99

Case 16 Acute deterioration in a 21-year-old man with
chronic hepatitis B virus infection, 106

Case 17 A 53-year-old man with a history of high alcohol
intake, 108

Case 18 A 57-year-old man with diabetes and elevated
alanine aminotransferase, 114

Case 19 A 42-year-old man with shortness of breath and
abnormal liver function tests, 120

Case 20 A 58-year-old man with diabetes and abnormal
liver function tests, 123

Case 21 A 16-year-old boy with cognitive deterioration,
ataxia and abnormal liver function tests, 126

Patients with deterioration in chronic liver
disease

Case 22 A 43-year-old man with a large gastrointestinal
bleed, 129

Case 23 A 58-year-old woman with a distended abdomen,
138

Case 24 A 67-year-old man with cirrhosis and confusion,
142

Case 25 A 47-year-old woman suddenly presents with
variceal haemorrhage, 146

Patients with abnormal radiological imaging

Case 26 A 37-year-old woman with abnormal liver
ultrasound, 150

Case 27 A 72-year-old man with right upper quadrant pain
and fever, 155

Case 28 A 52-year-old man with diarrhoea and a liver
mass, 159

Case 29 A 69-year-old man with a liver mass, 161

Liver transplantation

Case 30 A 56-year-old man with abnormal liver function
tests 4 weeks after liver transplantation, 164

Part 3 Self-assessment, 167

MCQs, 167

EMQs, 174

SAQs, 179

Answers, 181

Index of cases by diagnosis, 195

Index, 197