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List of contributors Foreword Acknowledgements 1 Anatomy and physiology Introduction The liver Hepatic microstructure Carbohydrate metabolism Fat metabolism Protein metabolism Clotting factors Storage of vitamins/iron Blood cleansing Processing of drugs and other xenobiotics Excocrine function Bilirubin Liver cirrhosis/fibrosis Chapter summary 2 Assessment of liver function and diagnostic studies Introduction Patient history Signs of liver disease Laboratory tests Diagnostic studies Complications and considerations Chapter summary Illustrative case study 3 Jaundice Introduction Classification of jaundice Bilirubin formation Bile functions Diseases of bilirubin metabolism Investigations Malabsorption Gallbladder disease Drug–induced jaundice Intrahepatic cholestasis of pregnancy Additional considerations Chapter summary Illustrative case study 4 Portal hypertension Introduction Definition Causes Consequences Clinical features Investigations Management of variceal haemorrhage Chapter summary Illustrative case study 5 Ascites, spontaneous bacterial peritonitis, hyponatraemia and hepatorenal failure Introduction Definition Classification Pathogenesis of ascites formation Diagnosis Treatment Spontaneous bacterial peritonitis Hyponatraemia Hepatorenal syndrome Chapter summary Illustrative case study 6 Hepatic encephalopathy Introduction Definition Pathophysiology of hepatic encephalopathy Classification of hepatic encephalopathy Diagnosis and investigations Treatment and management of hepatic encephalopathy Hepatic encephalopathy in acute liver failure Chapter summary Illustrative case study 7 Alcohol–related liver disease Introduction Incidence Metabolism of alcohol Pathophysiology Clinical features Alcoholic hepatitis Nursing considerations Alcohol–withdrawal therapies and protocols Chapter summary Illustrative case study 8 Non–alcoholic fatty liver disease Introduction Definition Disease prevalence Risk factors Natural history of NAFLD Clinical features Diagnosis Pathogenesis Disease management Chapter summary Illustrative case study 9 Viral hepatitis Introduction Hepatitis A virus Hepatitis E virus Hepatitis B virus Hepatitis D virus Hepatitis C virus Hepatitis and HIV co–infection Chapter summary Illustrative case study 10 Autoimmune hepatitis Introduction Pathogenesis Clinical features Classification Diagnosis Complications Variant syndrome Treatment Pregnancy and autoimmune hepatitis Liver transplantation Chapter summary Illustrative case study 11 Primary biliary cirrhosis and primary sclerosing cholangitis Introduction Primary biliary cirrhosis Primary sclerosing cholangitis Chapter summary Illustrative case study 12 Metabolic liver disease Introduction Wilson???s disease Haemochromatosis Alpha–1–antitryspin deficiency Cystic fibrosis Porphyria Chapter summary Illustrative case study 13 Acute liver failure Introduction Definition Aetiology Presentation Transfer criteria Disease management Liver transplantation Chapter summary Illustrative case study 14 Nutrition in liver disease Introduction Malnutrition and nutritional assessment Dietetic management of ascites Nutrition in hepatic encephalopathy Malabsorption and steatorrhoea Diabetes in liver disease Osteodystrophy Types of nutritional support in chronic liver disease Nutritional support in alcoholic liver disease Refeeding syndrome Non–alcoholic fatty liver disease Post–transplant nutrition Chapter summary 15 Drug–induced liver injury Introduction Mechanisms of hepatotoxicity Diagnosis of drug–induced liver injury Classification of drug injury Commonly used drugs that cause hepatotoxicity Herbal remedies for treatment in liver disease Chapter summary Illustrative case study 16 Pregnancy–related liver disease Introduction Normal changes during pregnancy Liver diseases specific to pregnancy Pregnancy in pre–existing liver disease Pregnancy post liver transplantation Chapter summary Illustrative case study 17 Hepatobiliary malignancies Introduction Definition Primary liver cancer Bile duct cancer Secondary liver cancer Diagnosing hepatobiliary malignancy Treatment options Nursing management Chapter summary Illustrative case study 18 Liver transplantation Introduction Indications for liver transplantation Pretransplant assessment Pretransplant education Consent Waiting list management Allocation of organs Liver transplant surgery Immunosuppressive therapy Graft rejection Discharge planning and patient information Quality of life following liver transplantation Long–term management in the liver recipient Chapter summary Illustrative case study Index