Most common liver diseases are fibrosis, cirrhosis and liver inflammation due to infections. Liver cirrhosis occurs due to scar tissue replacing normal liver cells because of chronic liver pathology. Symptoms of liver disease include weakness, fatigue, nausea, vomiting, weight loss, yellow discoloration of skin, yellow urine, pruritis, abdominal discomfort and pain, loss of appetite and inability to digest fatty food.

In cases of liver failure the symptoms are much worse and the patient may become confused, disoriented, and fatigued. This can lead to coma and sudden death [6]. If liver diseases are treated at the very initial phase, then there is a good chance of the person recovering well. Biliary tract obstruction, cholelithiasis and cholecystitis are biliary tract problems which can predispose to metabolic disorders.

• Pain

  If you do, you may have joint pain, fatigue, general weakness, weight loss, and stomach pain. Your doctor will diagnose hemochromatosis based on your medical and family histories, a physical exam, and the results from tests and procedures. [nlm.nih.gov]

  Abstract A 49-year-old Japanese woman with polycystic liver disease (PLD) was admitted for right hypochondrial pain. CT showed a huge enhancing mass in the liver. [ncbi.nlm.nih.gov]

• Fatigue

  Symptoms may include malaise, fatigue, nausea, abdominal discomfort or jaundice. Onset of symptoms typically occurs within one to 14 days and may include nausea, weakness, fatigue and abdominal pain. [memorialhermann.org]

  METHOD: The proband is a Swiss girl aged 4 investigated because of fatigue and elevated liver enzymes. Protein structure models were prepared using the Swiss-PdbViewer and POV-Ray software. [ncbi.nlm.nih.gov]

  Common liver disease symptoms: Jaundice Stomach varices bleeding Weakness and fatigue Abnormally high blood pressure Fluid buildup Liver enlargement and abdominal bloating Decline of cognitive function and forgetfulness Einstein’s liver experts deploy [einstein.edu]

  In cases of liver failure the symptoms are much worse and the patient may become confused, disoriented, and fatigued. This can lead to coma and sudden death. [symptoma.com]

• Easy Bruising

  Kidney disease or failure Easy bruising and severe bleeding. This happens when the liver stops making proteins that are needed for your blood to clot. Type 2 diabetes. [hopkinsmedicine.org]

  […] symptoms may include: Fluid buildup of the legs (edema) and in the abdomen ( ascites ) Yellow color in the skin, mucous membranes, or eyes ( jaundice ) Redness on the palms of the hands In men, impotence, shrinking of the testicles, and breast swelling Easy [nlm.nih.gov]

• Vomiting

  […] blood, or blood in the urine Shortness of breath Vomiting more than once a day Yellowing skin or eyes (jaundice) that is new or gets worse quickly Talk openly to your provider about your alcohol intake. [nlm.nih.gov]

  […] the skin and rashes – for autoimmune hepatitis Anorexia – for drug-induced hepatitis Fluid accumulation – for alcohol-induced hepatitis Cirrhosis symptoms include: Foot and abdominal swelling Nighttime sleep difficulty and increased daytime sleeping Vomiting [houstonmethodist.org]

  Abstract A 56-year-old white female presented to the emergency room (ER) with acute onset of right upper quadrant abdominal pain, nausea, and vomiting, and she was found to have a sudden drop in hemoglobin. [ncbi.nlm.nih.gov]

  It is characterized by poor feeding, vomiting, lack of energy (lethargy), abnormal movements and delayed development. If left untreated, it can lead to seizures, coma and death. [memorialhermann.org]

• Nausea

  Abstract A 56-year-old white female presented to the emergency room (ER) with acute onset of right upper quadrant abdominal pain, nausea, and vomiting, and she was found to have a sudden drop in hemoglobin. [ncbi.nlm.nih.gov]

  Symptoms: Symptoms may include nausea, vomiting, loss of apetitie, weight loss due to portal hypertension, distension of abdominal veins, confusion, disorientation. [symptoma.com]

  Others may have Loss of appetite Nausea and vomiting Diarrhea Dark-colored urine and pale bowel movements Stomach pain Jaundice, yellowing of skin and eyes Some forms of hepatitis are mild, and others can be serious. [nlm.nih.gov]

• Loss of Appetite

  See a GP if you have symptoms of cirrhosis, such as: feeling very tired and weak all the time loss of appetite – which may lead to weight loss loss of sex drive (libido) yellow skin and whites of the eyes ( jaundice ) Other symptoms may include itchy [nhs.uk]

  Others may have Loss of appetite Nausea and vomiting Diarrhea Dark-colored urine and pale bowel movements Stomach pain Jaundice, yellowing of skin and eyes Some forms of hepatitis are mild, and others can be serious. [nlm.nih.gov]

  Symptoms of liver disease can also include nausea, loss of appetite, fatigue and diarrhea. As liver failure progresses, one may experience a swollen abdomen, confusion, sleepiness, bleeding easily and coma. [beyondceliac.org]

• Abdominal Pain

  She was readmitted for acute abdominal pain with elevated blood pressure at 29 weeks of gestation. An emergency cesarean delivery was performed for severe preeclampsia. Her neonate was noted to have a distended abdomen. [ncbi.nlm.nih.gov]

  Call your provider if you develop ongoing abdominal pain, especially if you have a history of liver disease. Preventive measures include: Preventing and treating viral hepatitis may help reduce your risk. [nlm.nih.gov]

  Children may exhibit symptoms such as abdominal pain, which may be in the center or the right upper part of the abdomen, and sometimes fatigue. However, other causes of abdominal pain and fatigue should be considered. [patients.gi.org]

• Abdominal Mass

  Abdominal distension and abdominal masses, including: Possible massive ascites and anasarca due to fluid redistribution and hypoalbuminaemia. A dehydrated patient may not show much ascites. Hepatomegaly and splenomegaly but not invariably. [patient.info]

  Symptoms and signs of IBD include diarrhea, fecal incontinence, rectal bleeding, abdominal pain, fatigue, fever, nausea, vomiting, arthralgia, abdominal tenderness, palpable abdominal mass (usually inflamed loops of bowel) and perineal disease. [ssa.gov]

• Jaundice

  […] and weight loss Nausea Belly pain Small, red spider-like blood vessels on the skin As liver function worsens, symptoms may include: Fluid buildup of the legs (edema) and in the abdomen ( ascites ) Yellow color in the skin, mucous membranes, or eyes ( jaundice [nlm.nih.gov]

  We present the case of a patient without any prior liver disease who developed obstructive jaundice and a liver abscess due to peribiliary cysts. [ncbi.nlm.nih.gov]

  Liver-related symptoms include jaundice, fatigue, loss of appetite and abdominal swelling. [memorialhermann.org]

• Hepatomegaly

  CONCLUSIONS LAL-D should be included in the differential diagnosis of lipid metabolism disorder, hepatomegaly, and non-alcoholic fatty liver disease with fibrosis or cirrhosis. [ncbi.nlm.nih.gov]

  Diarrhea Hepatomegaly Hepatic cirrhosis No change or slower progression of liver failure. Right-upper quadrant pain Resolution or marked improvement. [web.archive.org]

  Rutin muayene sırasında hepatomegali, laboratuar olarak da ALTAST’de hafif yükselme (1-4 katı) bulunabilir. Ultrasonografi ucuz, noninvaziv ve kolay ulaşılabilir olması nedeniyle hepatosteatoz tanısında en sık kullanılan yöntemdir. [turkishfamilyphysician.com]

  Hepatomegaly and splenomegaly but not invariably. Cerebral oedema with increased intracranial pressure (ICP), may produce papilloedema, hypertension, and bradycardia. Liver palms are red and an hepatic flap, also called asterixis, may be present. [patient.info]

• Asterixis

  Constructional apraxia Patients cannot reproduce simple designs (e.g. a star of David) Drowsiness and confusion Parotid gland enlargement Spider angiomas Icterus Bilateral parotid swelling ( Credit ) Diminished axillary hair Spider angioma Gynecomastia in a male Asterixis [stanfordmedicine25.stanford.edu]

  Abnormal findings suggestive of cirrhosis include: Jaundice Spider angiomata Palmar erythema Caput medusa Palpable left lobe of the liver Splenomegaly Ascites Clubbing Asterixis Gynecomastia Testicular atrophy Temporal wasting Hypertrophic osteoarthropathy [hiv.va.gov]

  Liver palms are red and an hepatic flap, also called asterixis, may be present. Hyperextend the fingers and wrist, gently pushing back and a slow clonic movement is the liver flap. [patient.info]

• Liver Mass

  This report describes an older man with metabolic syndrome who developed a 3.9 cm. right lobe liver mass that on directed needle biopsy showed the features of an inflammatory hepatocellular adenoma, including immunostain positivity for serum amyloid A [ncbi.nlm.nih.gov]

• Liver Palms

  Liver palms are red and an hepatic flap, also called asterixis, may be present. Hyperextend the fingers and wrist, gently pushing back and a slow clonic movement is the liver flap. [patient.info]

• Night Blindness

  blindness Decreased energy and fatigue Mental confusion, which may progress to coma Vomiting blood or passing blood in the stools Edema (swelling) Cirrhosis is ultimately a terminal condition. [emoryhealthcare.org]

• Yellow Discoloration of the Skin

  Classic symptoms of liver disease include nausea, vomiting, right upper quadrant abdominal pain, and jaundice (a yellow discoloration of the skin due to elevated bilirubin concentrations in the bloodstream). [medicinenet.com]

• Dark Urine

  […] disease Poisons and drugs Infections Heart disease Genetic diseases Autoimmune disorders Medications Symptoms Many liver disease symptoms include: Fatigue Appetite loss Skin yellowing (jaundice) Fever Abdominal pain and swelling Nausea and vomiting Dark [houstonmethodist.org]

  Signs of liver disease that are more prominent are jaundice or yellowing of the eyes and skin, dark urine, very pale or light colored stool, bleeding from the GI tract, mental confusion, and retention of fluids in the abdomen or belly. [uihc.org]

  Symptoms Signs and symptoms of liver disease include: Skin and eyes that appear yellowish (jaundice) Abdominal pain and swelling Swelling in the legs and ankles Itchy skin Dark urine color Pale stool color, or bloody or tar-colored stool Chronic fatigue [mayoclinic.org]

  When this is severe, bile and its associated wastes accumulate in the liver, causing jaundice, dark brown urine, and pale-colored stools. [labtestsonline.org]

• Amenorrhea

  LESSONS: Physicians should consider the possibility of PRLoma when diet and exercise fail to improve fatty liver disease in a patient with endocrine symptoms such as amenorrhea. [ncbi.nlm.nih.gov]

  Roughly 20% of patients will be asymptomatic, with elevated transaminases identified on screening examination or during evaluation for amenorrhea, thyroid disease, arthralgia, or diabetes mellitus. [nature.com]

• Hot Flushes

  If this does not relieve the hot flushes it is important to check the liver function with a simple blood test to measure the liver enzymes. [liverdoctor.com]

• Irritability

  In Case 2, marked anger and irritation were exacerbated as a result of work, but the anger was controlled by anger management. Case 3 abused a minor tranquilizer, but limit-setting resulted in adequate medical adherence. [ncbi.nlm.nih.gov]

  There are many health-related drawbacks associated with drinking too much coffee, such as insomnia and irritable bowel syndrome, but scientists believe they’ve uncovered a positive effect. [qz.com]

  Conditions We Treat: Alpha-1 antitrypsin deficiency Barrett's esophagus Colitis Crohn's disease Fatty liver disease (NASH) Hepatitis C Hepatitis B Hepatorenal syndrome Inflammatory bowel disease (IBD) Irritable bowel syndrome (IBS) Liver cancer Pancreatitis [livercenter.slu.edu]

  Fecal transplant is used to treat gut infections and is now being studied as a treatment for obesity, urinary tract infections, irritable bowel syndrome and more. [nytimes.com]

  Some common problems include Heart burn/GERD, Irritable bowel syndrome and Lactose intolerence. Symptoms may include Bloating, diarrhoea, gas, stomach pain and stomach cramps. [scitechnol.com]

• Insomnia

  There are many health-related drawbacks associated with drinking too much coffee, such as insomnia and irritable bowel syndrome, but scientists believe they’ve uncovered a positive effect. [qz.com]

  […] variceal bleed, the combination of nonselective beta-blockers and endoscopic variceal ligation are recommended to decrease the risk of another bleed Hepatic Encephalopathy Overview: Variable abnormalities of neurological and psychiatric function, including insomnia [hiv.va.gov]

  Adverse effects may include: Anemia (ribavirin‑induced hemolysis), neutropenia, thrombocytopenia, fever, cough, fatigue, myalgia, arthralgia, nausea, loss of appetite, pruritis, and insomnia. Behavioral side effects may also occur. [ssa.gov]

• Headache

  Headache. Diarrhea. White stools. Rash. Build-up of fluid in the abdominal cavity. Jaundice (yellowing of eyes and skin). Enlarged liver. Fatigue. Weight loss. Loss of appetite. [drugabuse.com]

  Some infections cause flu-like symptoms of fever, headache, and weakness. Diagnosis Liver function tests, sometimes called a liver panel, measure various enzymes, proteins, and waste products in the blood. [medical-dictionary.thefreedictionary.com]

  Drug-induced headache. New York: Springer-Verlag; 1988. Chapter in a book: Weinsten L, Swartz NM. Pathological properties of invading microorganisms. In: Sodeman WA Jr, Sodeman WS, editors. Pathologic physiology: mechanisms of disease. [elsevier.com]

The various investigations of liver dysfunction include complete blood count (CBC), liver function tests, ferritin, hepatic enzymes, bilirubin, ammonia, lactate, blood gases, creatinine, free copper, phosphate, viral markers and drug screening. Biopsy, CT scan and MRI may also be useful to diagnose liver diseases.

• Gastric Varices

  With BRTO, an interventional radiologist makes a small incision in the groin and, using live x-rays, maneuvers a catheter through a large vein in the body (the inferior vena cava) into the veins in the stomach (gastric varices), typically next to the [sirweb.org]

  These veins—called varicose veins of the esophagus (esophageal varices) or stomach (gastric varices)—are fragile and prone to bleeding (see Gastrointestinal Bleeding ). [merckmanuals.com]

  Splanchnic hemodynamic pattern and liver function in patients with cirrhosis and esophageal or gastric varices. Am J Gastroenterol. 1997; 92(11): 2085-9. [sapd.es]

• Hyperammonemia

  An 84-year-old woman was hospitalized due to consciousness disorder as hyperammonemia. She had no etiology of liver disease. [ncbi.nlm.nih.gov]

  […] clinical signs including photosensitization, jaundice, hepatic encephalopathy in the form of the dummy syndrome, dullness and anorexia, or there may be subclinical disease detectable by clinicopathological tests, e.g. hypoglycemia, hypoproteinemia, hyperammonemia [medical-dictionary.thefreedictionary.com]

  Briefly, hyperammonemia may be involved in the development of cerebral edema. Brain edema is thought to be both cytotoxic and vasogenic in origin. Cytokine profiles are also deranged. [emedicine.medscape.com]

• Hypercholesterolemia

  Lipoprotein-X has several properties that make it anti-atherogenic, which raises the question if treatment for hypercholesterolemia should be initiated. [ncbi.nlm.nih.gov]

  […] addition the bile fluid is an important liquid through which the execretion of metabolised hormones (in particular steroids ) and the haemoglobin remnant bilirubin can be achieved. 4 Pathology In case of a to high concentration of cholesterine (for example hypercholesterolemias [flexikon.doccheck.com]

  | N Engl J Med 2018; 378:e26 A 49-year-old man with severe hypercholesterolemia and a history of biliary cirrhosis presented with painful xanthoma striatum palmare, which abated after weekly low-density lipoprotein apheresis. [nejm.org]

• Hypoglycemia

  The immune system malfunctions, increasing the risk of infections People may have metabolic abnormalities, such as a low potassium level in the blood ( hypokalemia ) or a low blood sugar level ( hypoglycemia ). [merckmanuals.com]

  Symptoms can include slow growth, low muscle tone, heat intolerance, bruising, low blood sugar (hypoglycemia), enlarged liver, abdominal swelling and muscle pain and cramping during exercise. [memorialhermann.org]

  There may be clinical signs including photosensitization, jaundice, hepatic encephalopathy in the form of the dummy syndrome, dullness and anorexia, or there may be subclinical disease detectable by clinicopathological tests, e.g. hypoglycemia, hypoproteinemia [medical-dictionary.thefreedictionary.com]

• Hyponatremia

  While on waiting lists, these patients developed severe hyponatremia (< 125 mEq/L) that was refractory to conventional therapies. [ncbi.nlm.nih.gov]

  […] every 6-12 months 11-18: at least every 3 months 19-24: at least every month ≥25: at least every week Refer for transplant evaluation if: Child-Turcotte-Pugh score is ≥7 or MELD score is ≥15 MELD score is 11-13 and patient has refractory ascites or hyponatremia [hiv.va.gov]

• Hypoalbuminemia

  Signs/Symptoms of Cirrhotic Decompensation Causes Upper GI bleeding Variceal hemorrhage Confusion Encephalopathy Abdominal distention Ascites Edema Hypoalbuminemia Jaundice Hyperbilirubinemia (liver insufficiency) Dyspnea Pleural effusion (hydrothorax [hiv.va.gov]

  You may also have signs or laboratory findings indicating malnutrition, such as weight loss, edema, anemia, hypoalbuminemia, hypokalemia, hypocalcemia, or hypomagnesemia. 3. [ssa.gov]

• Hepatocellular Carcinoma

  Abstract Nonalcoholic fatty liver disease (NAFLD) represents a spectrum of disorders from simple steatosis to inflammation leading to fibrosis, cirrhosis, and even hepatocellular carcinoma. [ncbi.nlm.nih.gov]

  Exome sequencing of hepatitis B virus-associated hepatocellular carcinoma. Nat. Genet. 44, 1117–1121 (2012). 28. Cleary, S. P. et al. Identification of driver genes in hepatocellular carcinoma by exome sequencing. [doi.org]

Patients with acute liver failure develop circulatory dysfunction. Fluid and hemodynamic support should be provided to these patients. Noting down and keeping a record of metabolic parameters, infection control, proper nutrition, and observation of gastrointestinal bleeding if any are steps of management of various liver diseases. Clotting factors, complete blood cell count, and liver functions should be measured time to time [7]. Serum aminotransferases and bilirubin are recorded daily to follow the pattern of the disease.

Antibiotics are given if liver disease due to infection. Penincillamine and zinc therapy are used in patients with metabolic diseases. Prednisone and azathioprine are given to suppress the immune system. Spironolactone and furesimide diuretics are used in patients with ascites. Lactulose and neomycin are employed to treat encephalopathy. Appropiate doses of vitamins help in the absorption of fat thus preventing fatty liver [8].

Prognosis of liver diseases is good in early detection of disease. Diet control and treating the underlying causes can help prevent liver dysfunction. Chronic cases like congenital anomalies, chronic liver failure and liver cirrhosis have a poor prognosis, where only intensive care can be provided to the patient by keeping a check over his liver functions and trying to improve the condition by supportive medication.

Cytomegalovirus is the major cause of liver infections in most cases of acute liver disease. Hepatitis is the major causes of chronic diseases of liver. Azathioprine is responsible for acute cholestasis, but could not be identified as a direct cause of chronic disease.

Other viruses and diseases affecting liver are adenoviruses, coxsackie virus, rubella, yellow fever, arena viruses and ebola virus disease. Bacterial, fungal, spirochetal infections, rickettsial infections and vascular disorders like arteriosclerosis, amyloidosis, aneurysms, infarcts, eclampsia may also affect the liver function. Drug induced liver injury, portal vein thrombosis, veno-occlusive diseases, congenital disorders, right and left heart failure are some of the abnormalities possibly affecting the liver. Graft-versus-Host reaction, hepatic autograft rejection, autoimmune cholangitis and idiopathic adulthood ductopenia may lead to liver function disorders [3].

The true reason for the liver disease precipitation is unknown; there can be many causes both external and internal that can induce liver diseases. Alcoholic liver diseases are common, which can cause liver cirrhosis and liver failure. Epidemiological studies vary quite a lot all over the world with respect to the prevalence and incidence of liver diseases. No predisposition in a particular population is found for liver diseases, but hepatitis B has an overall higher prevalence rate than hepatitis A and C in causing liver functional disorders [4].

General pathology of liver diseases include cellular changes, reaction to any injury, inflammation, repair, fibrosis, tissue changes and cholestasis. Liver pathology is seen in two basic patterns, one is dystrophy and the second is necrosis. If broadly classified, the different pathological presentation of liver in different conditions is as follows:

In liver cirrhosis, autoimmune cells are present comprising predominantly of T lymphocytes, bile duct damage and vanished bile ducts. Accumulation of lymphocytes, plasma cells and histolytic are seen in the portal area.

Hepatitis, folic acid deficiency and hypovitaminosis may cause fatty liver. Hypoxia is an important factor in fatty liver infiltration. In long standing cases, fatty dystrophy of liver may follow.

When copper gets deposited in the hepatocytes it results in Wilson’s disease, it also affects central nervous system and joints. Urea synthesis disorder can lead to the accumulation of urea and hepatic encephalopathy. Hepatocerebral coma may be a result of hepatic disease, toxic liver dystrophy and cirrhosis.

Disorders of bile production can lead to jaundice, steatorrohea and cholemia. In cholelithiasis, there is an obstruction of bile duct and elevated levels of conjugated bilirubin, predisposing to clay like stools and black colored urine.

Alcoholic liver disease is characterized by hepatocyte swelling and necrosis, Mallory body formation, fibrosis and neutrophilic reaction. Portal hypertension is characterized by caput medusa (varicose veins of abdomen), ascites and splenomegaly [5].

Stopping intake of alcohol and drug overuse can prevent progression of liver pathology. Vaccines should be administered in order to prevent occurrence of various types of hepatitis. Obesity and diabetes may cause fatty liver. Medicines should be used wisely. Contact should be avoided with people with infected blood and body fluids. Increase in body weight should be kept under check [9].

Classification of liver disease can be based on many types. Liver disease can be induced by variety of agents ranging from alcohol, drugs, infections, and hereditary causes. Infections may result from virus, bacteria and other pathogens.

Viral hepatitis (A, B, C, D and E) is a disease of major concern. Toxic agents like alcohol, drugs and environmental pollutants may also result in liver diseases. Autoimmune diseases and biliary cirrhosis cause liver injury. Autoimmune disease include Wilson's disease, Budd–Chairi syndrome, Chyle fistula, hemochromatosis, inborn error of metabolism, Antitrypsin 1 deficiency, and autoimmune hepatitis.

Hepatic cysts and hepatic hemangiomas are conditions which may result in liver malfunction. Benign neoplasm, malignant conditions, like hepatocellular carcinoma and adenoma, can also affect liver resulting in liver failure [2].

Definition: Liver disease is the dysfunction of any of the liver functions related to nutrition, absorption, digestion, blood clotting and toxin elimination. Any problem in the metabolic activities of liver relating to the vital functions of metabolism, clotting and immunogenicity may predispose to liver disease.

Cause: Causes of the liver disease can be alcohol overuse, drug misuse, obesity, diabetes, deficiency of multivitamins and obstruction of bile duct. Reasons of predisposition of liver disease can be hereditary which may include diseases like Wilson’s disease, Gilbert’s syndrome and antitrypsin deficiency. Other reasons are viral, bacterial and fungal infections.

Symptoms: Symptoms may include nausea, vomiting, loss of apetitie, weight loss due to portal hypertension, distension of abdominal veins, confusion, disorientation.

Diagnosis: Diagnosis may be made by presenting symptoms like itching, yellow discoloration of skin. Liver function tests and other diagnostic measurements are used in diagnosing liver diseases. Some conditions may require liver biopsy and imaging studies.

Treatment: Antibiotics are given commonly in liver disease. Treatment with diuretics, and other drugs is according to the disease condition [10]. Rifampin, naloxone, acetaminophen, azathioprine and multivitamins are other common drugs given in liver malfunction.

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2. Gray H, Lewis WH. Gray's Anatomy of the Human Body. 20th Ed. New York, NY: Bartleby; 2000
3. Nelson PK, Mathers BM, Cowie B, Hagan H, Des Jarlais D, Horyniak D, et al. Global epidemiology of hepatitis B and hepatitis C in people who inject drugs: results of systematic reviews. Lancet. Aug 13 2011;378(9791):571-83.
4. Calmus Y, Gane P, Rouger P, et al. Hepatic expression of class I and class II major histocompatibility complex molecules in primary biliary cirrhosis: effect of ursodeoxycholic acid. Hepatology. Jan 1990;11(1):12-5.
5. Telem DA, Schiano T, Goldstone R, Han DK, Buch KE, Chin EH. Factors that predict outcome of abdominal operations in patients with advanced cirrhosis. Clin Gastroenterol Hepatol. May 2010;8(5):451-7, quiz e58.
6. Costa-Pinho A, Melo RB, Graca L, Lopes JM, Costa-Maia J. Multiple Hepatic Inflammatory Pseudotumours Diagnosed after Laparoscopic Excisional Biopsy. J Clin Diagn Res. Aug 2013;7(8):1730-1731.
7. D'Albuquerque LA, de Miranda MP, Genzini T, Copstein JL, de Oliveira e Silva A. Laparoscopic cholecystectomy in cirrhotic patients. Surg Laparosc Endosc. Aug 1995;5(4):272-6.
8. Pronovost P, Dorman T, Sadovnikoff N, Garrett E, Breslow M, Rosenfeld B. The association between preoperative patient characteristics and both clinical and economic outcomes after abdominal aortic surgery. J Cardiothorac Vasc Anesth. Oct 1999;13(5):549-54.
9. Testino G, Sumberaz A, Ancarani AO, Borro P, Ravetti G, Ansaldi F, et al. Influence of body mass index, cholesterol, triglycerides and steatosis on pegylated interferon alfa-2a and ribavirin treatment for recurrent hepatitis C in patients transplanted for HCV and alcoholic cirrhosis. Hepatogastroenterology. Mar-Apr 2009;56(90):501-3.
10. Phillips M, Curtis H, Portmann B, Donaldson N, Bomford A, O'Grady J. Antioxidants versus corticosteroids in the treatment of severe alcoholic hepatitis- A randomized clinical trial. J Hepatol. Apr 2006;44:784-90.