honeypot link
skip to main content
Professional
Consumer
Professional edition active
ENGLISH
MSD Manual
Professional Version
MEDICAL TOPICS
RESOURCES
COMMENTARY
PROCEDURES
QUIZZES
ABOUT US
MEDICAL TOPICS
RESOURCES
COMMENTARY
PROCEDURES
QUIZZES
Professional
/
Hepatic and Biliary Disorders
/
Hepatic and Biliary Disorders
Expand all
Collapse all
Approach to the Patient With Liver Disease
Liver Structure and Function
Overview of liver structure
Overview of bilirubin metabolism
Pathophysiology
Evaluation of the Patient With a Liver Disorder
History
Physical examination
Testing
The Asymptomatic Patient With Abnormal Liver Test Results
Aminotransferases
Alkaline phosphatase
Acute Liver Failure
Etiology
Pathophysiology
Symptoms and Signs
Symptoms and signs references
Diagnosis
Diagnosis reference
Treatment
Treatment references
Prognosis
Key Points
Ascites
Etiology
Pathophysiology
Symptoms and Signs
Diagnosis
Treatment
Treatment reference
Key Points
Inborn Metabolic Disorders Causing Hyperbilirubinemia
Crigler-Najjar Syndrome
Dubin-Johnson Syndrome and Rotor Syndrome
Dubin-Johnson syndrome
Rotor syndrome
Gilbert Syndrome
Primary Shunt Hyperbilirubinemia
Jaundice
Pathophysiology
Mechanisms of hyperbilirubinemia
Consequences
Etiology
Evaluation
History
Physical examination
Red flags
Interpretation of findings
Testing
Treatment
Geriatrics Essentials: Jaundice
Key Points
Metabolic Dysfunction–Associated Liver Disease (MASLD)
Pathophysiology
Symptoms and Signs
Diagnosis
Diagnosis references
Treatment
Prognosis
Prognosis references
Key Points
Portal Hypertension
Etiology
Pathophysiology
Symptoms and Signs
Diagnosis
Treatment
Treatment reference
Prognosis
Key Points
Portosystemic Encephalopathy
Etiology
Precipitants
Pathophysiology
Symptoms and Signs
Diagnosis
Treatment
Prognosis
Key Points
More Information
Postoperative Liver Dysfunction
Postoperative jaundice
Postoperative hepatitis
Postoperative cholestasis
Spontaneous Bacterial Peritonitis (SBP)
Symptoms and Signs
Diagnosis
Treatment
Systemic Abnormalities in Liver Disease
Circulatory Abnormalities
Endocrine Abnormalities
Hematologic Abnormalities
Renal and Electrolyte Abnormalities
Hepatorenal syndrome
Pulmonary Abnormalities
Testing for Hepatic and Biliary Disorders
Laboratory Tests of the Liver and Gallbladder
Tests for Liver Injury
Aminotransferases
Lactate dehydrogenase (LDH)
Tests for Cholestasis
Bilirubin
Alkaline phosphatase (ALP)
5′-Nucleotidase
Gamma–glutamyl transpeptidase (GGT)
Tests of Hepatic Synthetic Capacity
Prothrombin time (PT) and international normalized ratio (INR)
Serum proteins
Other Laboratory Tests
Ammonia
Serum immunoglobulins
Antimitochondrial antibodies
Other antibodies
Alpha-fetoprotein (AFP)
Tests for hepatic fibrosis
Other laboratory tests reference
More Information
Imaging Tests of the Liver and Gallbladder
Ultrasonography
Doppler ultrasonography
Computed tomography (CT)
Magnetic resonance imaging (MRI)
Endoscopic retrograde cholangiopancreatography (ERCP)
Percutaneous transhepatic cholangiography (PTC)
Operative cholangiography
Cholescintigraphy
Radionuclide liver scanning
Plain x-ray of the abdomen
References
Liver Biopsy
Indications
Contraindications
Contraindications references
Other routes
Other routes references
Alcohol-Related Liver Disease
Alcohol-Related Liver Disease
Reference
Risk Factors
Quantity of alcohol
Sex
Genetic factors
Nutritional status
Other factors
Risk factors references
Pathophysiology
Alcohol absorption and metabolism
Hepatic fat accumulation
Endotoxins in the gut
Oxidative damage
Resultant inflammation, cell death, and fibrosis
Pathology
Symptoms and Signs
Diagnosis
Diagnosis reference
Treatment
Restricting alcohol intake
Supportive care
Specific treatment
Treatment references
Prognosis
Key Points
Drugs and the Liver
Effects of Liver Disease on Drug Metabolism
Liver Injury Caused by Drugs
References
Pathophysiology
Patterns of liver injury
Pathophysiology references
Diagnosis
Diagnosis references
Treatment
Prevention
Key Points
Fibrosis and Cirrhosis
Hepatic Fibrosis
Etiology
Pathophysiology
Symptoms and Signs
Diagnosis
Diagnosis references
Treatment
Key Points
Cirrhosis
General reference
Etiology
Pathophysiology
Complications
Histopathology
Pathophysiology reference
Symptoms and Signs
Diagnosis
General approach
Laboratory tests
Diagnostic imaging
Identification of the cause
Liver biopsy
Monitoring
Diagnosis references
Treatment
Treatment reference
Prognosis
Child-Turcotte-Pugh classification for severity of liver disease
Model for end-stage liver disease (MELD)
Pediatric end-stage liver disease (PELD) score
Treatment reference
Key Points
Primary Biliary Cholangitis (PBC)
Etiology
Symptoms and Signs
Diagnosis
Diagnosis reference
Treatment
Treatment references
Prognosis
Key Points
Gallbladder and Bile Duct Disorders
Overview of Biliary Function
Acalculous Biliary Pain
General reference
Diagnosis
Diagnosis reference
Treatment
General reference
Acute Cholecystitis
Acute acalculous cholecystitis
Symptoms and Signs
Complications
Acute acalculous cholecystitis
Diagnosis
Acute acalculous cholecystitis
Treatment
Key Points
AIDS Cholangiopathy
Diagnosis
Treatment
Chronic Cholecystitis
Symptoms and Signs
Diagnosis
Treatment
Choledocholithiasis and Cholangitis
General reference
Diagnosis
Treatment
Treatment reference
Key Points
Cholelithiasis
General reference
Pathophysiology
Pathophysiology reference
Symptoms and Signs
Diagnosis
Treatment
Surgery
Stone dissolution
Treatment references
Prognosis
Prognosis references
Key Points
Postcholecystectomy Syndrome
General reference
Diagnosis
Diagnosis reference
Treatment
Primary Sclerosing Cholangitis (PSC)
Etiology
Etiology reference
Symptoms and Signs
Symptoms and signs references
Diagnosis
Diagnosis reference
Treatment
Treatment references
Key Points
Sclerosing Cholangitis
IgG4-Related Sclerosing Cholangitis
General reference
Symptoms and Signs
Diagnosis
Treatment
Treatment reference
Key Points
Tumors of the Gallbladder and Bile Ducts
General reference
Symptoms and Signs
Diagnosis
Treatment
Key Points
Hepatitis
Causes of Hepatitis
Common Causes
Less Common Causes
General reference
Overview of Acute Viral Hepatitis
Etiology
Symptoms and Signs
Diagnosis
Initial diagnosis of acute hepatitis
Serology
Biopsy
Treatment
Treatment reference
Prevention
General measures
Immunoprophylaxis
Key Points
Fulminant Hepatitis
Symptoms and Signs
Diagnosis
Treatment
Overview of Chronic Hepatitis
Etiology
Common causes
Less common causes
Etiology references
Classification
Symptoms and Signs
Diagnosis
Liver tests
Other laboratory tests
Biopsy
Screening for complications
Diagnosis references
Treatment
General treatment
Chronic hepatitis B and C
Metabolic dysfunction-associated steatohepatitis (MASH)
Autoimmune hepatitis
Hereditary hemochromatosis
Prognosis
Key Points
More Information
Hepatitis A
General references
Symptoms and Signs
Diagnosis
Other tests
Treatment
Prevention
Vaccination
Postexposure prophylaxis
Prevention reference
Key Points
More Information
Hepatitis B, Acute
Transmission of hepatitis B
General reference
Symptoms and Signs
Diagnosis
Other tests
Treatment
Prevention
Vaccination
Postexposure prophylaxis
Key Points
More Information
Hepatitis B, Chronic
General references
Symptoms and Signs
Diagnosis
Other tests
Screening for complications
Diagnosis reference
Treatment
Treatment reference
Key Points
More Information
Hepatitis C, Acute
Transmission of hepatitis C
General reference
Symptoms and Signs
Diagnosis
Other tests
Treatment
Treatment reference
Prevention
Prevention reference
Key Points
More Information
Hepatitis C, Chronic
General references
Symptoms and Signs
Screening
Screening reference
Diagnosis
Other tests
Screening for complications
Treatment
Overview of HCV treatment
Treatment references
Prognosis
Prognosis references
Key Points
More Information
Hepatitis D
Symptoms and Signs
Diagnosis
Treatment
Prevention
Key Points
Hepatitis E
Reference
Symptoms and Signs
Diagnosis
Treatment
Treatment reference
Prevention
Key Points
Liver Masses and Granulomas
Hepatic Cysts
Reference
Hepatic Granulomas
Etiology
Etiology references
Pathophysiology
Symptoms and Signs
Diagnosis
Treatment
Prognosis
Key Points
Benign Liver Tumors
Hepatocellular Adenoma
References for hepatocellular adenoma
Focal Nodular Hyperplasia
Focal nodular hyperplasia reference
Hemangiomas
References for hemangiomas
Other Benign Tumors
Hepatocellular Carcinoma
References
Etiology
Symptoms and Signs
Diagnosis
Staging
Screening
Diagnosis references
Treatment
Treatment references
Prevention
Key Points
Other Primary Liver Cancers
Other Primary Liver Cancers
Fibrolamellar carcinoma
Cholangiocarcinoma
Hepatoblastoma
Angiosarcoma
Cystadenocarcinoma
References
Metastatic Liver Cancer
Symptoms and Signs
Diagnosis
Treatment
Hematologic Cancers and the Liver
Vascular Disorders of the Liver
Overview of Vascular Disorders of the Liver
Reference
Budd-Chiari Syndrome
Etiology
Etiology reference
Symptoms and Signs
Diagnosis
Treatment
Treatment reference
Prognosis
Key Points
Congestive Hepatopathy
Symptoms and Signs
Diagnosis
Diagnosis references
Treatment
Hepatic Artery Aneurysms
Reference
Hepatic Artery Occlusion
Symptoms and Signs
Diagnosis
Treatment
Ischemic Cholangiopathy
Etiology
Symptoms and Signs
Diagnosis
Treatment
Ischemic Hepatitis
Etiology
Symptoms and Signs
Diagnosis
Treatment
Treatment reference
Peliosis Hepatis
Portal Vein Thrombosis
Etiology
Etiology reference
Symptoms and Signs
Diagnosis
Diagnosis reference
Treatment
Treatment references
Key Points
Sinusoidal Obstruction Syndrome
Etiology
Symptoms and Signs
Diagnosis
Treatment
Treatment references
