Evaluating the Patient with Liver Disease

 Until the advanced stages of cirrhosis, the identification of liver disease can be challenging for clinicians. In the earlier stages of the condition, most forms of chronic liver disease are asymptomatic or associated with vague and rather nonspecific complaints, such as fatigue. Even in the setting of cirrhosis, liver enzymes may be normal or mildly elevated. Patients with liver disease are currently recognized through a variety of routes, including screening programs, routine laboratory testing, and imaging performed for other complaints. This review contains 5 figures, 10 tables and 64 references Key Words: Primary biliary cirrhosis, Variceal hemorrhage, hepatocellular carcinoma, Hepatitis A, B and C, Discriminant function, Liver biopsy, Alcoholic liver disease, Autoimmune hepatitis, Hemochromatosis, Nonalcoholic fatty liver disease, Wilson disease