Liver (Anatomy and Function) (cont.)
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Bhupinder S. Anand, MBBS, MD, DPHIL (OXON)
Dr. Anand received MBBS degree from Medical College Amritsar, University of Punjab. He completed his Internal Medicine residency at the Postgraduate Institute of medical Education and Research, Chandigarh, India. He was trained in the field of Gastroenterology and obtained the DPhil degree. Dr. Anand is board-certified in Internal Medicine and Gastroenterology.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Facts about the liver
- What is the function of the liver?
- What are symptoms of liver diseases?
- What does the liver look like, and where is it located in the body?
- Liver disease causes (fatty liver, cirrhosis, hepatitis, and infections)
- Liver disease causes (medications, toxins, genetics, cancer, and others)
- What kind of doctor treats liver disease?
- How is an examination of the liver performed?
- What is a liver biopsy?
- Can diseases of the liver be prevented?
- Find a local Doctor in your town
What kind of doctor treats liver disease?
Diseases of the liver may be treated by primary care or internal medicine specialists. Gastroenterologists are specialists that focus on the digestive organs and liver. A hepatologist is a specialist focused exclusively on the liver. Depending upon the exact type of liver disease, other specialists may be involved in the care of patients with liver disease, including infectious disease specialists, surgeons, oncologists, critical care specialists, hematologists, and emergency medicine specialists.
How is an examination of the liver performed?
The liver is located in the abdomen but the health care professional will want to examine the whole body to look for the consequences of liver disease.
- The abdomen may be palpated to feel for an enlarged liver. As it grows, the liver edge may be felt below the right rib margin. An inflamed liver in acute hepatitis may be tender but a liver that is cirrhotic, small and shrunken, may not be able to be felt.
- If liver disease is a consideration, the health care professional also may feel for an enlarged spleen and assess whether excess fluid is present in the abdomen (ascites), perhaps indicating the presence of portal hypertension.
- The skin, including the sclera of the eyes, may be assessed for color looking for jaundice. Spider nevi, or angiomata, are a collection of blood vessels under the skin and may be normal, but in the proper setting may indicate liver disease.
- If the person is confused (hepatic encephalopathy), the doctor may attempt to illicit asterixis, or flap on the physical examination. These people may not be able to keep their wrists cocked when their arms are held outstretched but instead see their wrists rhythmically flapping.
- Blood tests may be ordered to help make the diagnosis. Liver enzymes levels may reveal liver inflammation. However, in patients with end-stage liver disease, the liver can burn itself out and the enzymes may be normal even in the face of severe disease. Other blood tests that may be appropriate include a complete blood cell count (CBC), hepatitis virus screen, and blood clotting tests (a sensitive way to measure function since the liver is responsible for manufacturing the proteins involved in the blood clotting mechanism).
- On occasion, ultrasound may be helpful in assessing the anatomy of the liver and this may lead to other tests including CT scan to further assess the anatomy and structure of the liver and surrounding tissues.
Next: What is a liver biopsy?
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