By A. Paton (Auth.)
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Extra resources for Liver Disease
Itching often precedes jaundice by some months. There is no pain, appetite and general well-being are preserved and weight loss is minimal. Jaundice is moderate in intensity and obstructive in nature and is accompanied by skin pigmentation so that the patient appears suntanned. One woman was mistaken for a West Indian because of the depth of pigmentation. Scratch marks and occasionally bruising may be present (Fig. 20). The hair colour is often characteristically titian or reddish and there is frequently finger clubbing and shiny nails.
Death may also occur in the acute stage from hepatic necrosis with a shrinking liver and signs of liver failure (sometimes without jaundice) but this is fortunately rare and well over 95 per cent of patients recover completely even from severe attacks. It is still debatable whether an attack of hepatitis can be followed after an interval of normal health by cirrhosis. Follow-up studies of large numbers of British troops affected by hepatitis in the Middle East during the last war and patients in the Delhi epidemic of 1955-56 have failed to show an increased incidence of cirrhosis, but they have so far been conducted only for 15 years.
Liver scan using radioactive gold in a patient with cirrhosis. The shrunken liver is well shown together with marked uptake of radioactivity by the enlarged spleen. Ultrasound. A beam of ultrasound can be directed into the body and the echoes recorded by B-scan as points of brightness on a Polaroid film. If the probe moves automatically across the abdomen just below the costal margin with an inclination towards the patient's head a scan can be obtained which, by suitable adjustment, shows the anterior and posterior surfaces of the normal liver with a clear area between.
Liver Disease by A. Paton (Auth.)