3. Introduction
• Hepatic disease is a type of damage to
or disease of the liver.
• The liver is a vital organ of the digestive system.
• Functions: Detoxification, protein synthesis,
glycogen storage, decomposition of red blood
cells and production of biochemicals necessary
for digestion.
4. Anatomy
The liver is a reddish brown organ with four lobes of unequal
size and shape.
Weighs 1.44–1.66 kg
Triangular organ.
It is both the largest internal organ and the largest gland.
It lies below the diaphragm in the
abdominal-pelvic region of the abdomen.
The liver lies to the right of the
stomach and overlies the gallbladder
5. Signs and symptoms of liver problems include:
Discolored skin and eyes
Abdominal pain and swelling
Itchy skin
Dark urine color
Pale stool color
Bloody or tar-colored stool
Chronic fatigue
Nausea
Loss of appetite
7. Hepatitis is from the
Greek word hēpat- meaning
liver, and suffix -itis, meaning
"inflammation"
Characterized by the presence of
inflammatory cells in
the tissue of the organ.
The condition can be self-
limiting or can progress to
fibrosis and cirrhosis.
8. May occur with limited or no symptoms, but often
leads to jaundice, poor appetite and malaise.
Hepatitis is acute when it lasts less than six
months and chronic when it persists longer.
Worldwide, hepatitis viruses are the most common
cause of the condition,
It can also be caused by other infections, toxic
substances, and autoimmune diseases.
9. Alcoholic hepatitis
• Excessive alcohol consumption is a significant cause of hepatitis
and cirrhosis.
• Develops over years-long exposure to alcohol.
• Alcohol intake in excess of 80 grams of alcohol a day in men and
40 grams a day in women is associated with alcoholic hepatitis.
• Elevated transaminases, usually with elevation of aspartate
transaminase (AST) to alanine transaminase (ALT) in a 2:1 ratio.
• The combination of hepatitis C and alcohol consumption
accelerates the development of cirrhosis
10. A large number of medications and other chemical agents
can cause hepatitis.
Antibiotics, paracetamol and central nervous
system medications are among the most common.
Risk factors include: increasing age, female sex, and
previous drug-induced hepatitis, genetic variability
Toxins and medications can cause direct cell damage,
disrupting cell metabolism, and inducing structural
changes.
Exposure to other hepatotoxins can occur accidentally or
intentionally through ingestion, inhalation, and skin
absorption.
11. Autoimmune hepatitis is a chronic disease caused by an
abnormal immune response against liver cells.
The disease is thought to have a genetic predisposition.
The disease occurs in people of all ages but most
commonly in young women.
Many people with autoimmune hepatitis have other
autoimmune diseases.
Autoimmune hepatitis
12. Injury to liver cells due to insufficient blood or oxygen results in
ischemic hepatitis (or liver shock).
The condition is most often associated with heart failure but
can also be caused by shock or sepsis.
Very high levels of transaminase enzymes(AST and ALT)
The condition usually resolves if the underlying cause is
treated successfully.
Ischemic hepatitis rarely causes permanent liver damage.
13. Giant Cell Hepatitis
• Giant cell hepatitis is a rare form of hepatitis.
• Predominantly occurs in newborns and
children.
• Diagnosis is made on the basis of the
presence of multinucleated hepatocyte giant
cells on liver biopsy.
• The cause of giant cell hepatitis is unknown
but the condition is associated with viral
infection, autoimmune disorders, and drug
toxicity.
14. CIRRHOSIS
Cirrhosis from greek word ‘kirrhos’
"yellowish" and suffix -sis meaning
"condition’’.
Result of advanced liver disease.
It is characterized by replacement of
liver tissue by fibrosis and regenerative nodules (occur due
to attempted repair of damaged tissue).
These changes lead to loss of liver function.
Cirrhosis is most commonly caused
by alcoholism, hepatitis B and hepatitis C, and fatty liver
disease.
15. Ascites is the most common complication of cirrhosis.
It is associated with a poor quality of life, increased risk of
infection, and a poor long-term outcome.
Irreversible, and treatment usually focuses on preventing
progression and complications.
In advanced stages of cirrhosis the only option is a liver
transplant.
16. PBC is an autoimmune disease
Marked by the slow progressive destruction of the
small bile ducts of the liver.
When these ducts are damaged, bile builds up in
the liver (cholestasis) and over time damages the
tissue.
This can lead to scarring, fibrosis and cirrhosis.
17. Some fat in the liver is normal.
But if fat makes up more than 5%-10% of
the weight of the liver, it may cause alcoholic or
nonalcoholic liver disease. In some cases, these
diseases can lead to serious complications.
18. 1. ALCOHOLIC LIVER DISEASE (ALD)
Fatty liver can occur after drinking moderate or large
amounts of alcohol.
It can even occur after a short period of heavy drinking
(acute alcoholic liver disease).
Genetics or heredity plays a role in alcoholic liver disease
It may also affect liver enzymes involved in the breakdown
(metabolism) of alcohol.
19. The most common cause of chronic liver disease
Some people with excess fat in the liver simply have a
fatty liver.
Although this is not normal, it is not serious if it doesn't
lead to inflammation or damage.
20. 3. Nonalcoholic Steatohepatisis (NASH)
• It is similar to alcoholic liver disease.
• People with this type of fatty liver disease drink little or
no alcohol.
• The liver may enlarge and, over time, liver cells may
be replaced by scar tissue called cirrhosis.
• NASH can lead to permanent liver damage.
• May develop liver failure, liver cancer, and liver-related
death.
21. Liver cancer
Liver cancer or hepatic cancer is the fifth most frequently
diagnosed cancer globally and the second leading cause of cancer
death.
Malignant tumors that grow on the surface or inside the liver.
Primary liver cancer are formed from either the liver itself or from
structures within the liver, including blood vessels or the bile duct.
Discovered on medical imaging equipment (often by accident) or
present themselves symptomatically as an abdominal
mass, abdominal pain, jaundice, nausea or liver dysfunction.
Causes: Viral infection, Cirrhosis, Aflatoxin
22. Gilbert's syndrome
A genetic liver disorder.
The most common hereditary cause of increased
bilirubin.
A major characteristic is jaundice, caused by elevated
levels of unconjugated bilirubin in the bloodstream
(hyperbilirubinemia).
Conjugated bilirubin is excreted in bile into the
duodenum.
23. DIAGNOSTICS
• A number of liver function tests (LFTs) are available
to test the proper function of the liver.
• These test for the presence of enzymes in blood
that are normally most abundant in liver tissue,
metabolites or products.
• Serum proteins, serum albumin, serum globulin,
alanine transaminase, aspartate
transaminase, prothrombin time, partial
thromboplastin time, platelet count.
24. Diet must help the liver function and protects it from
working too hard.
Less amount of protein.
Less fat.
Increasing intake of carbohydrates.
Limiting salt intake. Salt in the diet may worsen fluid
buildup and swelling in the liver.
