Liver Disease: General Pathophysiology, Diagnosis, and Management

  • Clinical Updates in Women's Health Care CU
  • November 2016

ABSTRACT: Approximately one third of American adults have a chronic hepatobiliary disease 1. The multiple etiologies include alcoholic liver disease, nonalcoholic fatty liver disease, viral hepatitis, autoimmune liver diseases, drug-induced liver injury, and genetic or metabolic diseases. Most patients have few or no symptoms, but many have abnormal liver test results or serum bilirubin levels. Cirrhosis, regardless of the etiology of the underlying liver disease, is a risk factor for hepatocellular carcinoma. Because obstetrician–gynecologists provide both general and specialized care to adolescents and adult women, it is important that they understand the basics of liver anatomy and physiology, significance of abnormal liver test results and abnormal levels of serum bilirubin, and strategies for additional testing and imaging required for diagnosis. Several hepatobiliary diseases occur with greater frequency in women than in men, whereas others affect women differently from men. Early diagnosis and therapy offer the best hope for preventing the progression of hepatobiliary diseases to cirrhosis, liver failure, and the need for liver transplantation. Obstetrician–gynecologists should develop strong working relationships with consultants in hepatology and liver transplantation to promote the best outcomes for their patients.

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