Hepatology

What is Hepatology?

Hepatology is the branch of medicine that incorporates study of liver, gallbladder, biliary tree and pancreas as well as management of their disorders. Etymologically the word ''Hepatology'' is formed of ancient Greek ''hepar''(ηπαρ) or ''hepato-''(ηπατο-) meaning ' liver' and suffix ''-logia''(-λογια) meaning 'word' or 'speech'. 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.

Diseases and complications related to viral hepatitis and alcohol are the main reason for seeking specialist advice. One third of world population has been infected with Hepatitis B virus at some point in their life. Although most of them would clear the virus from the body, approximately 350 million have become persistent carriers. Up to 80% of liver cancers can be attributed to either hepatitis B or Hepatitis C virus.

In terms of number of mortality, the former is second only to smoking among known agents causing cancer. With more widespread implementation of vaccination and strict screening before blood transfusion, lower infection rates are expected in the future. In many countries, though, overall alcohol intake is on the rise, and consequently the number of people with cirrhosis and other related complications is increasing.

As for many medical specialties, patients are most likely to be referred by family physicians ( i.e. GP) or by doctors from different disciplines. The reasons might be:

  • Drug overdose. Paracetamol overdose is common.
  • Gastrointestinal bleeding from portal hypertension related to liver damage
  • Abnormal blood test suggesting liver disease
  • Enzyme defects leading to bigger liver in children commonly named storage disease of liver
  • Jaundice / Hepatitis virus positivity in blood, perhaps discovered on screening blood tests
  • Ascites or swelling of abdomen from fluid accumulation, commonly due to liver disease but can be from other diseases like heart failure
  • All patients with advanced liver disease e.g. cirrhosis should be under specialist care
  • To undergo ERCP for diagnosing diseases of biliary tree or their management
  • Fever with other features suggestive of infection involving mentioned organs. Some exotic tropical diseases like hydatid cyst, kala-azar or schistosomiasis may be suspected. Microbiologists would be involved as well
  • Systemic diseases affecting liver and biliary tree e.g. haemochromatosis
  • Follow up of liver transplant
  • Pancreatitis - commonly due to alcohol or gall stone
  • Cancer of above organs. Usually multi-disciplinary approach is under taken with involvement of oncologist and other experts.

This article is licensed under the Creative Commons Attribution-ShareAlike License. It uses material from the Wikipedia article on "Hepatology" All material adapted used from Wikipedia is available under the terms of the Creative Commons Attribution-ShareAlike License. Wikipedia® itself is a registered trademark of the Wikimedia Foundation, Inc.

Hepatology History

Evidence from autopsies on Egyptian mummies suggest that liver damage from parasitic infection Bilharziasis was widespread in the ancient society.

It is possible that the Greeks may have been aware of the liver's ability to exponentially duplicate as illustrated by the story of Prometheus. However, knowledge about liver disease in antiquity is questionable. Most of the important advances in the field have been made in the last 50 years.

  • In 400 BC Hippocrates mentioned liver abscess in apporium .
  • Roman anatomist Galen thought the liver was the principle organ of the body. He also identified its relationship with the gallbladder and spleen.
  • Around 100CE Areteus of cappadoca wrote on jaundice
  • In medieval period Avicenna noted the importance of urine in diagnosing liver conditions.
  • 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
  • In 1958, Moore developed a standard technique for canine orthotopic liver transplantation.
  • The first human liver transplant was performed in 1963 by Dr. Thomas E. Starzl on a 3-year-old male afflicted with biliary atresia after perfecting the technique on canine livers.,
  • Baruch S. Blumberg discovered Hepatitis B virus in 1966 and developed first vaccine against it 1969. He was awarded the Nobel Prize in Physiology or Medicine 1976.

This article is licensed under the Creative Commons Attribution-ShareAlike License. It uses material from the Wikipedia article on "Hepatology" All material adapted used from Wikipedia is available under the terms of the Creative Commons Attribution-ShareAlike License. Wikipedia® itself is a registered trademark of the Wikimedia Foundation, Inc.