Hepatology Diagnosis and Clinical Management

This book will be an affordable, highly practical handbook on hepatology, aimed at residents/trainees in gastroenterology, GI nurses, and recently qualified consultants to use as a quick reference when managing patients presenting with possible or overt liver disease.

It will be of particular use for those GI internists/residents who have an interest specifically in hepatology. It does not aim to be a specialist textbook, but a shorter, 250pp guide that provides key clinical information on each area of hepatology in an accessible form. Extracting relevant material from large reference textbooks can be very time consuming and for this reason, information in this handbook will be presented succinctly in a style suitable for quick reference and easy understanding.

The chief emphasis will be on the clinical assessment and management of these patients, and all the major areas of liver disease will be covered, from liver cirrhosis to viral hepatitis, to autoimmune liver failure.

Chapters will use a variety of structural features and colour coded boxes to increase the accessibility for residents. These include: key points/take-home points, case history, practice points and management algorithm/flow-charts. Each chapter will also contain sample multiple choice questions that the reader will be able to test themselves on.

Contributors ix

Foreword xii

Preface xiv

Acknowledgements xv

1 Clinical Assessment of the Adult Patient with Possible Liver Disease: History and Physical Examination 1
Eberhard L. Renner

2 Initial Diagnosis, Workup, and Assessment of Severity of Liver Disease in Adults 13
Scott K. Fung

3 Pediatric Liver Disease: An Approach to Diagnosis and Assessment of Severity 31
Binita M. Kamath and Vicky L. Ng

4 Natural History of the Cirrhotic Patient 45
Jordan J. Feld

5 Management of Complications of Portal Hypertension in Adults and Children: Variceal Hemorrhage 63
E. Jenny Heathcote Simon Ling and Binita M. Kamath

6 Management of Ascites 80
David K.H. Wong

7 Masses in the Liver 93
Morris Sherman

8 Chronic Portosystemic Encephalopathy and Its Management 112
Leslie B. Lilly and Binita M. Kamath

9 Indications for Liver Transplantation in Adults and Children 119
Nazia Selzner and Vicky L. Ng

10 Management of Fulminant Hepatic Failure 132
Leslie B. Lilly

11 Management of the Complications of Liver Transplantation 142
Eberhard L. Renner and Eve A. Roberts

12 Acute Viral Hepatitis in Adults and Children: Hepatitis A, B, C, D, E, and Others 162
Hemant A. Shah and Eve A. Roberts

13 Chronic Viral Hepatitis in Adults and Children: Hepatitis B 185
Jordan J. Feld

14 Chronic Viral Hepatitis in Adults and Children: Hepatitis C 208
Eberhard L. Renner and Eve A. Roberts

15 Liver Disease Due to Alcohol 226
Nazia Selzner

16 Drug-Induced Liver Disease 235
Leslie B. Lilly

17 Obesity and Its Hepatic Complications in Adults and Children 244
E. Jenny Heathcote and Eve A. Roberts

18 HIV-Associated Liver Diseases 263
David K.H. Wong

19 Autoimmune Hepatitis in Adults and Children 281
Gideon M. Hirschfield

20 Chronic Cholestatic Liver Disease and Its Management in Adults and Children 297
Gideon M. Hirschfield and Binita M. Kamath

21 Vascular Diseases of the Liver 315
Jordan J. Feld

22 Approach to Metabolic and Storage Diseases 329
Hemant A. Shah and Eve A. Roberts

23 Wilson Disease: When Should You Think of Wilson Disease? 352
Eve A. Roberts and Gideon M. Hirschfield

24 Liver Disease in Pregnant Women 367
E. Jenny Heathcote

25 Cystic Disease of the Liver 383
Morris Sherman

26 An Internist’s Approach to Radiologic Examination of the Liver 396
Anthony E. Hanbidge and Korosh Khalili

Index 413 

Dr. Jenny Heathcote, MB.BS, M.D, FRCP, FRCP, is Professor of Medicine at the?University of Toronto. She graduated from the Royal Free Hospital School of Medicine, London, UK in 1968. After completing internship and residency in internal medicine, she moved to Stanford, USA for further research training and joined the Toronto Western Hospital, where she has since built up an internationally recognized clinical liver research unit with a major interest in viral hepatitis and autoimmune liver disease. She is a Senior Scientist in the Toronto Western Research Institute where she is Division Head of "Patient Based Clinical Research".
Dr. Heathcote has been a Professor at the University of Toronto since 1995, winning numerous awards in a stellar career, including:?Queen's Jubilee Medal for services to hepatology;?Canadian Liver Foundation Gold Medal at the Canadian Digestive Diseases Week in 2004; the Canadian Liver Foundation Lifetime Achievement Award 2004; American Association for the Study of Liver Diseases Distinguished Achievement Award 2005;?International Sheila Sherlock Award from the Falk Foundation 2006.
She was funded from 2003 — 2009 by the Canadian?Institutes of Health Research, and was Director of the CIHR funded National Canadian Research Training Program in Hepatitis C. She now heads up the NIH funded Toronto site for the North American Clinical network for chronic hepatitis B.
She has published over 200 papers in the area of autoimmune liver disease and chronic viral hepatitis.