‫‪LIVER DISORDERS‬‬

‫ﻋﻼ ﺑﺎﺳﻢ ﻋﺒﺪ اﻟ‪,‬ﺎﻇﻢ‬

‫‪.‬ﻠﻴﺔ اﻟﻄﺐ ‪ /‬اﳌﺮﺣﻠﺔ اﻟﺜﺎﻧﻴﺔ‬
The liver is one of the most sensitive and accurate organs in the body in •
terms of function, so you must protect your liver from any serious
injuries that may cause it. What are the primary symptoms of your liver
disease?
There is no doubt that the liver helps digest food and convert it into •
energy stored in the body, and it also plays an important role in filtering
toxins from your blood.

When the liver does not function properly due to liver disease, this may •
have serious health effects, causing primary symptoms that affect the
liver in particular and other parts of the body.
 FAST FACTS ON THE LIVER :

The liver is classed as a gland.

This vital organ carries out more
than 500 roles in the human body.
It is the only organ that can
regenerate.
The liver is the largest solid organ
in the body.
Alcohol abuse is one of the major Real photo of Hepatocellular
causes of liver problems in the carcinoma
industrialized world.
 AN ORGAN AS COMPLEX AS THE LI VER C AN EXPERI ENC E A RANGE OF
PROBLEMS. A HEALTHY LI VER FUNCTI ONS VERY EFFI CI ENTLY. HOWEVER, IN A
DI SEASED OR MALFUNCTI ONI NG LI VER, THE CONSEQUENCES CAN BE
DANGEROUS OR EVEN FATAL EXAMPLES OF LIVER DISEASE INCLUDE:

• Fascioliasis: This is caused by the parasitic invasion of a parasitic worm known as a liver
fluke, which can lie dormant in the liver for months or even years. Fascioliasis is
considered a tropical disease.
• Cirrhosis: This sees scar tissue replace liver cells in a process known as fibrosis. This
condition can be caused by a number of factors, including toxins, alcohol, and hepatitis.
Eventually, fibrosis can lead to liver failure as the functionality of the liver cells is
destroyed.
• Hepatitis: Hepatitis is the name given to a general infection of the liver, and viruses,
toxins, or an autoimmune response can cause it. It is characterized by an inflamed liver.
In many cases, the liver can heal itself, but liver failure can occur in severe cases.
• Alcoholic liver disease: Drinking too much alcohol over long periods of time can cause
liver damage. It is the most common cause of cirrhosisin the world.
• Primary sclerosing cholangitis (PSC): PSC is a serious inflammatory disease of the bile ducts that
results in their destruction. There is currently no cure, and the cause is currently unknown, although
the condition is thought to be autoimmune.
• Fatty liver disease: This usually occurs alongside obesity or alcohol abuse. In fatty liver disease,
vacuoles of fat build up in the liver cells. If it is not caused by alcohol abuse, the condition is called
non-alcoholic fatty liver disease (NAFLD).
• It is usually caused by genetics, medications, or a diet high in fructose sugar. It is the most common
liver disorder in developed countries and has been associated with insulin resistance. Non-alcoholic
steatohepatitis (NASH) is a condition that can develop if NAFLD gets worse. NASH is a known cause
of liver cirrhosis.
• Gilbert’s syndrome: This is a genetic disorder affecting 3 to 12 percent of the population. Bilirubin is
not fully broken down. Mild jaundicecan occur, but the disorder is harmless.
• Liver cancer: The most common types of liver cancer are hepatocellular carcinoma and
cholangiocarcinoma. The leading causes are alcohol and hepatitis. It is the sixth most commonform
of cancer and the second most frequent cause of cancer death.
 WHAT ARE THE SYMPTOMS OF LIVER DISEASE?

There are some symptoms of liver disease that may afflict you in the event
of a liver
injury, which should then refer to medical advice, including:
-Jaundice or discoloration of the skin and eyes in yellow
-Swelling of the legs and ankles -Vomiting and nausea -fever
-Unexplained bruising on the skin
Anorexia
-Chronic fatigue and fatigue
Pain and flatulence
-Joint and muscle pain -Your stools may be pale, black, or bloody.

W H AT A RE T H E C AU SE S T H AT
L EA D TO L I V E R D I SEASE ?
• The causes that lead to liver
problems are classified as
follows:
• 1- Immune system dysfunction
• 2- Hereditary causes
• 3- Infection (such as hepatitis)
• 4- Hepatocellular carcenoma
The ways to prevent liver disease
are :
-Avoid consuming too much alcohol and
consuming it in moderate amounts
-You should follow preventative advice
regarding transmission of personal hygiene
To prevent hepatitis
-You should take all the special foods that
protect you from hepatitis
-Maintaining a healthy weight, healthy body,
and a balanced diet away from high-fat foods
-Avoid contact with any pesticides or
chemicals or infect your skin.
 • It occurs in the setting of chronic liver
O N E O F T H E M O ST I M P O RTA N T
A N D DA N G E RO U S D I SEASE S inflammation, and is most closely linked
A F F E C T I N G T H E L I V E R I S: to chronic viral hepatitis infection
(hepatitis B or C) or exposure to toxins
such as alcohol or aflatoxin. Certain
diseases, such as hemochromatosis and
Hepatocellular carcinoma (HCC) is
alpha 1-antitrypsin deficiency, markedly
the most common type of primary
increase the risk of developing HCC.
liver cancer in adults, and is the Metabolic syndrome and NASH are also
most common cause of death in increasingly recognized as risk factors for
people with cirrhosis. HCC.
• As with any cancer, the treatment and
prognosis of HCC vary depending on the
specifics of tumor histology, size, how far
the cancer has spread, and overall health.
 SIGNS AND SYMPTOMS

• Most cases of HCC occur in people who already have signs and
symptoms of chronic liver disease. They may present either with
worsening of symptoms or may be without symptoms at the time of
cancer detection. HCC may directly present with yellow skin,
abdominal swelling due to fluid in the abdominal cavity, easy
bruising from blood clotting abnormalities, loss of appetite,
unintentional weight loss, abdominal pain, nausea, vomiting, or
feeling tired.
 RISK FACTORS
HCC mostly occurs in people with
cirrhosis of the liver, and so risk •Chronic viral hepatitis (estimated cause of 80% cases
factors generally include factors globally)
which cause chronic liver disease Chronic hepatitis B (about 50% cases) Chronic hepatitis C
that may lead to cirrhosis. Still, (about 25% cases)
certain risk factors are much more • Toxins:
highly associated with HCC than Alcohol abuse: the most common cause of cirrhosis
others. For example, while heavy
Aflatoxin. Iron overload state (hemochromatosis)
alcohol consumption is estimated
to cause 60–70% of cirrhosis, the •Metabolic:
vast majority of HCC occurs in Nonalcoholic steatohepatitis: up to 20% progress
to cirrhosis
cirrhosis attributed to viral
hepatitis (although there may be Type 2 diabetes (probably aided by obesity)
overlap) Recognized risk factors Congenital disorders: Alpha 1-antitrypsin deficiency
include: Wilson's disease
 DIAGNOSIS
• On ultrasound, HCC often appears as a small
• Methods of diagnosis in HCC have
evolved with the improvement in
medical imaging. The evaluation of
both asymptomatic patients and
those with symptoms of liver disease
involves blood testing and imaging
evaluation. Although historically a
biopsy of the tumor was required to
prove the diagnosis, imaging
(especially MRI) findings may be
conclusive enough to obviate
histopathologic confirmation.
hypoechoic lesion with poorly defined margins
and coarse, irregular internal echoes. When the
tumor grows, it can sometimes appear
heterogeneous with fibrosis, fatty change, and
calcifications. This heterogeneity can look
similar to cirrhosis and the surrounding liver
parenchyma. A systematic review found that the
sensitivity was 60% (95% CI 44–76%) and
specificity was 97% (95% CI 95–98%) compared
with pathologic examination of an explanted or
resected liver as the reference standard. The
sensitivity increases to 79% with AFP
correlation.
Treatment of hepatocellular carcinoma varies by the stage of disease, a
person's likelihood to tolerate surgery, and availability of liver transplant :

• 1- Curative intention: for limited disease, when the cancer is limited to one or more areas of
within the liver, surgically removing the malignant cells may be curative. This may be
accomplished by resection the affected portion of the liver (partial hepatectomy) or in
some cases by orthotopic liver transplantation of the entire organ.
• 2- Bridging" intention: for limited disease which qualifies for potential liver
transplantation, the person may undergo targeted treatment of some or all of the known
tumor while waiting for a donor organ to become available.
• 3- "Downstaging" intention: for moderately advanced disease which has not spread beyond
the liver, but is too advanced to qualify for curative treatment. The person may be treated
by targeted therapies in order to reduce the size or number of active tumors, with the goal
of once again qualifying for liver transplant after this treatment.
• 4- Palliative intention: for more advanced disease, including spread of cancer beyond the
liver or in persons who may not tolerate surgery, treatment intended to decrease symptoms
of disease and maximize duration of survival.
 REFERENCES

1- Forner A, Llovet JM, Bruix J (2012). "Hepatocellular carcinoma". The

Lancet
2- liver cancer overview". Mayo Clinic
3- Heidelbaugh, Joel J.; Bruderly, Michael (2006-09-01). "Cirrhosis and
chronic liver failure: part I. Diagnosis and evaluation". American Family
Physician.
4- Alter MJ (2007). "Epidemiology of hepatitis C virus infection". World
Journal of Gastroenterology
5- “prevention”