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Hepatology Print E-mail

Dr. Kennedy Evidence from Egyptian mummies suggest liver damage from parasitic infection with Bilharziasis was widespread. The Greeks may have been aware of liver's ability to regenerate itself as illustrated by Prometheus story. However knowledge about liver diseases in antiquity was some what sketchy. Most of the important advances in the field have been made in last 50 years. A brief list of liver highlights follows:

  • 400 BC Hippocrates mentioned liver abscess in apporium .
  • 200 BC Roman anatomist Galen thought liver is the principle organ of the body. He also identified its relationship with gallbladder and spleen.
  • 100 AD Areteus of Cappadoca wrote on jaundice
  • 1770 French anatomist Antoine Portal, noted bleeding due to oesophageal varices]
  • 1844 Gabriel Valentin showed pancreatic juices break down food in digestion
  • 1846 Justus Von Leibig discovered pancreatic juice tyrosine
  • 1862 Austin Flint described the production of "stercorin"
  • 1875 Victor Charles Hanot described cirrhotic jaundice and other diseases of liver
  • 1958 Moore developed a standard technique for canine orthotopic liver transplantation.
  • 1963 The first human liver transplant was performed in by Dr. Thomas E. Starzl

Hepatology is the branch of medicine which incorporates liver, gallbladder, biliary tree and pancreas and management of their disorders. Although traditionally considered a sub-specialty of gastroenterology, rapid expansion has led in some countries to doctors specialising solely on this area, who are called Hepatologists. Doctors who specialize in managing the medical aspects of liver transplants are termed Transplant Hepatologists

Diseases and complications related to viral hepatitis and alcohol are the main reasons people seek medical aid. One third of world population has been infected with Hepatitis B virus at some point in their life. Although most clear the virus, approximately 350 million have become persistent carriers. Up to 80% of liver cancers can be attributed to either Hepatitis B or Hepatitis C virus. Hep-C is second only to smoking among known agents causing cancer. In many countries overall alcohol intake is on the rise and the number of people with cirrhosis and other related complications are increasing.

The conditions for which people seek out a hepatologist are as follows:

  • Jaundice
  • Gastrointestinal bleeding from portal hypertension related to liver damage
  • Abnormal blood test suggesting liver disease
  • Enzyme defects leading to liver enlargement
  • Hepatitis virus positivity in blood
  • Swelling of the abdomen from fluid accumulation, commonly due to liver disease but can be from other diseases like heart failure
  • Advanced liver disease (e.g. cirrhosis) should be under specialist care
  • To undergo ERCP (Endoscopic Retrograde Cholangiopancreatography) for diagnosing diseases of biliary tree or their management
  • Fever with other features suggestive of infection involving the liver, gallbladder or pancreas
  • Damage to the liver from other toxins (commonly drugs). (Paracetamol overdose is common )
  • Systemic diseases affecting liver and biliary tree e.g. hemochromatosis
  • Follow up of liver transplant
  • Pancreatitis - commonly due to alcohol abuse or gallstones
  • Cancer of the liver, pancrease or biliary system

The information in this article is not meant to be medical advice.�Treatment for a medical condition should come at the recommendation of your personal physician.

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