Hepatology: Clinical Cases Uncovered

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