Skip to main content
SpringerLink
Log in

The Clinician Looks at Fatty Liver

  • Chapter
Book cover Modern Concepts in Gastroenterology Volume 2

Part of the book series: Topics in Gastroenterology ((TGEN))

  • 61 Accesses

Abstract

Fatty liver is now being diagnosed more often than in the past. The diagnosis may follow a clinically suspicious condition, e.g., unexplained hepatomegaly, but increasingly it accompanies the use of special techniques such as computerized tomography (CT), ultrasound, and liver biopsy.1 In some instances the cause of fatty liver is obvious, such as alcoholism or obesity. In other instances the fatty change is a small part of another condition such as non-A, non-B hepatitis or Wilson’s disease. It may be an integral part of a widespread metabolic abnormality such as Reye’s syndrome. Finally, there remains a large group for whom the cause of the fatty liver is never determined.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Sherlock S. Diseases of the Liver and Biliary System, 7th ed. Oxford: Blackwell Scientific, 1985; pp. 381–385.

    Google Scholar 

  2. Hoyumpa AM, Green HL, Dunn GD, Schenker S. Fatty liver: Biochemical and clinical considerations. Dig Dis Sci 1975;20:1142–1170.

    Article  CAS  Google Scholar 

  3. Saverymuttu SH, Joseph AEA, Maxwell JD. Ultrasound scanning in the detection of hepatic fibrosis and steatosis. MJ 1986;292:13–15.

    Article  CAS  Google Scholar 

  4. Scatarige JC, Scott WW, Donovan PJ et al. Fatty infiltration of the liver: Ultrasonographic and computed tomographic correlation. J Ultrasound Med 1984;3:9–14.

    PubMed  CAS  Google Scholar 

  5. McKee CM, Weir PE, Murnaghan GA, Callender ME. Acute fatty liver of pregnancy and diagnosis by computed tomography. Br Med J 1986;292:291–292.

    Article  CAS  Google Scholar 

  6. Bydder GM, Kreel L, Chapman RWG, Harry D, Sherlock S. Accuracy of computed tomography in diagnosis of fatty liver. Br Med J 1980;281:1042–1044.

    Article  PubMed  CAS  Google Scholar 

  7. Heiken JP, Lee JKT, Dixon WT. Fatty infiltration of the liver: Evaluation by proton spectroscopic imaging. Radiology 1985;157:707–710.

    PubMed  CAS  Google Scholar 

  8. Scheuer PJ. Liver Biopsy Interpretation, 3rd ed. London: Bailliere-Tindall, 1980.

    Google Scholar 

  9. Baptista A, Bianchi L, DeGroote J et al. Alcoholic liver disease: Morphological manifestations. Review by an international group. Lancet 1981;1:707–711.

    Google Scholar 

  10. Uchida T, Kao H, Quispe-Sjogren M et al. Alcoholic foamy degeneration: A pattern of acute alcoholic injury of the liver. Gastroenterology 1983;84:683–692.

    PubMed  CAS  Google Scholar 

  11. Christoffersen P, Braendstrup O, Juhl E et al. Lipogranulomas in human liver biopsies with fatty change. Acta Pathol Microbiol Scand Sec A 1971;19:150–158.

    Google Scholar 

  12. Sorensen TIA, Orholm M, Bentsen KD et al. Prospective evaluation of alcohol abuse and alcoholic liver injury in men as predictors of the development of cirrhosis. Lancet 1984;2:241–243.

    Article  PubMed  CAS  Google Scholar 

  13. Randall BR. Fatty liver and sudden death: A review. Hum Pathol 1980;11:147–153.

    Article  PubMed  CAS  Google Scholar 

  14. Braillon A, Capron JP, Herve MA, Degott C, Quenu MC. Liver in obesity. Gut 1985;26:133–139.

    Article  PubMed  CAS  Google Scholar 

  15. Nasrulla SM, Wills CE Jr, Galambos JT. Hepatic morphology in obesity. Dig Dis Sci 1981;26:325–327.

    Article  Google Scholar 

  16. Adler M, Schaffner F. Fatty liver, hepatitis and cirrhosis in obese patients. Am J Med 1979;67:811–816.

    Article  PubMed  CAS  Google Scholar 

  17. Moran JR, Ghishan FK, Halter SA, Greene HL. Steatohepatitis in obese children: A cause of chronic liver dysfunction. Am J Gastroenterol 1983;78:374–377.

    PubMed  CAS  Google Scholar 

  18. Mavrelis PG, Ammon HV, Gleysteen JJ et al. Hepatic free fatty acids in alcoholic liver disease and morbid obesity. Hepatology 1983;3:226–231.

    Article  PubMed  CAS  Google Scholar 

  19. Sherlock S, Beam AG, Billing B. The effect of insulin on the liver in normal and diabetic man. In Trans 10th Conf Liver Injury. New York: Josiah Macy Jr. Foundation.

    Google Scholar 

  20. Bray GA. Complications of obesity. Ann Intern Med 1985;103:1052–1062.

    PubMed  CAS  Google Scholar 

  21. Cherrington AD, Steiner KE. The effects of insulin on carbohydrate metabolism in vivo. Clin Endocrinol Metab 1982;11:307–328.

    Article  PubMed  CAS  Google Scholar 

  22. Robbers H, Strohfeldt P, Kruger CH. Differential diagnosis between diabetic and alcoholic fatty liver: A study of 171 diabetics and 100 chronic alcoholics. German Med Monthly 1968;13:124–125.

    CAS  Google Scholar 

  23. Itoh S, Tsukada Y, Motomura Y, Ichinoe A. Five patients with nonalcoholic diabetic cirrhosis. Acta Hepatogastroenterol 1979;26:90–97.

    CAS  Google Scholar 

  24. Falchuk KR, Fiske SC, Haggitt RC, Federman M, Trey C. Pericentral hepatic fibrosis and intracellular hyalin in diabetes mellitus. Gastroenterology 1980;78:535–541.

    PubMed  CAS  Google Scholar 

  25. Batman PA, Scheuer PJ. Diabetic hepatitis preceding the onset of glucose intolerance. Histopathology 1985;9:237–243.

    Article  PubMed  CAS  Google Scholar 

  26. McGill DB, Hympherys SR, Baggenstoss AH, Dickson ER. Cirrhosis and death after jejunoileal shunt. Gastroenterology 1972;63:872–877.

    PubMed  CAS  Google Scholar 

  27. Haines NW, Baker AL, Boyer JL et al. Prognostic indicators of hepatic injury following jejunoileal bypass performed for refractory obesity: A prospective study. Hepatology 1981;1:161–167.

    Article  PubMed  CAS  Google Scholar 

  28. Wolfe RR, O’Donnell TF, Stone MD et al. Investigation of factors determining the optimal glucose infusion rate in total parenteral nutrition. Metabolism 1980;29:892–900.

    Article  PubMed  CAS  Google Scholar 

  29. Kaminski DL, Adams A, Jellinek M. The effect of hyperalimentation on hepatic lipid content and lipogenic enzyme activity in rats and man. Surgery 1980;88:93–100.

    PubMed  CAS  Google Scholar 

  30. Bengoa JM, Hanauer SB, Sitrin MD, Baker AL, Rosenberg IH. Pattern and prognosis of liver function test abnormalities during parenteral nutrition in inflammatory bowel disease. Hepatology 1985;5:79–84.

    Article  PubMed  CAS  Google Scholar 

  31. Truswell AS, Hansen JDL, Watson CE, Wannenburg P. Relation of serum lipids and lipoproteins to fatty liver in kwashiorkor 1,2. Am J Clin Nutr 1969;22:568–576.

    PubMed  CAS  Google Scholar 

  32. Cook GC, Hutt MSR. The liver after kwashiorkor. Br Med J 1967;3:454–457.

    Article  PubMed  CAS  Google Scholar 

  33. Avigan MI, Ishak KG, Gregg RE, Hoofnagle JH. Morphologic features of the liver in abeta-lipoproteinemia. Hepatology 1984;4:1223–1226.

    Article  PubMed  CAS  Google Scholar 

  34. Beaugrant M, Poupon R, Levy VG et al. Lesions hepatiques dues au maleate de perhexiline. Etude clinique, biologique, histopathologique, ultrastructurale et biochemique de 7 cas. Gastroenterol Clin Biol 1978;2:579–588.

    Google Scholar 

  35. Poucell S, Ireton J, Valencia-Mayoral P et al. Aminodarone-associated phospholipidosis and fibrosis of the liver: Light, immunohistochemical and electron microscopic studies. Gastroenterology 1984;86:926–936.

    PubMed  CAS  Google Scholar 

  36. Morgan MY, Reshef R, Shah RR, Oates NS, Smith RL, Sherlock S. Impaired oxidation of debrisoquine in patients with perhexiline liver injury. Gut 1984;25:1057-.

    Article  PubMed  Google Scholar 

  37. Simon JB, Manley PN, Brien JF, Armstrong PW. Amiodarone hepatoxicity simulating alcoholic liver disease. N Engl J Med 1984;311:167–172.

    Article  PubMed  CAS  Google Scholar 

  38. Seki K, Minami Y, Nishikawa M et al. Non-alcoholic steatohepatitis induced by massive doses of synthetic estrogen. Gastroenterol Japan 1983;18:197–203.

    CAS  Google Scholar 

  39. Gyorgy P, Goldblatt H. Hepatic injury on nutritional basis in rats. J Exp Med 1939;70:185–192.

    Article  PubMed  CAS  Google Scholar 

  40. Hartroft WS. Intracellular (“pseudo-alcoholic”) lyalin in experimental dietary cirrhosis of rats and mice. Am J Pathol 1958;34:603.

    Google Scholar 

  41. Dordal E, Glagov S, Kirsner JB. Hepatic lesions in chronic inflammatory bowel disease. 1. Clinical correlations with liver biopsy diagnosis in 103 patients. Gastroenterology 1967;52:239–253.

    PubMed  CAS  Google Scholar 

  42. Eade MN. Liver disease in ulcerative colitis. 1. Analysis of operative liver biopsy in 138 consecutive patients having colectomy. Ann Intern Med 1970;72:475–487.

    PubMed  CAS  Google Scholar 

  43. Neale G, Antcliff AC, Welbourn RB, Mollin DL, Booth CC. Protein malnutrition after partial gastrectomy. Q J Med 1967;36:469–94.

    PubMed  CAS  Google Scholar 

  44. Kimura H, Kako M, Yo K, Oda T. Alcoholic hyalins (Mallory bodies) in a case of Weber-Christian disease: Electron microscopic observations of liver involvement. Gastroenterology 1980;78:807–812.

    PubMed  CAS  Google Scholar 

  45. Kryger P, Christoffersen P. Light microscopic morphology of acute hepatitis non-A, non-B: A comparison with hepatitis type A and B. Liver 1982;2:200.

    PubMed  CAS  Google Scholar 

  46. Alvarez SJ. Chronic hepatitis with fatty changes. Hepatology 1983;3:1058 (abstract).

    Google Scholar 

  47. Bruguera M, Zambon D, Ros E, Sanchhez Tapias JM, Rodes J. Chronic hepatitis: A possible etiology of fatty liver. Liver 1985;5:111–116.

    PubMed  CAS  Google Scholar 

  48. Altman AR, Gottfried EB, Paronetto F, Lieber CS. Idiopathic familial cirrhosis and steatosis in adults. Gastroenterology 1979;77:1211–1216.

    PubMed  CAS  Google Scholar 

  49. Sherlock S. Acute fatty liver of pregnancy and the microvesicular fat diseases. Gut 1983;24:265–269.

    Article  PubMed  CAS  Google Scholar 

  50. Burroughs AK, Seong NH, Dojcinov DM, Scheuer PJ, Sherlock SVP. Idiopathic acute fatty liver of pregnancy in 12 patients. Q J Med 1982;481–497.

    Google Scholar 

  51. Pockros PJ, Peters RL, Reynolds TB. Idiopathic fatty liver of pregnancy: Findings in ten cases. Medicine (Baltimore) 1984;63:1–11.

    Article  PubMed  CAS  Google Scholar 

  52. Kaplan MM. Current concepts. Acute fatty liver of pregnancy. N Engl J Med 1985;313:367–370.

    Article  PubMed  CAS  Google Scholar 

  53. Weber FL Jr, Snodgrass PJ, Powell DE, Rao P, Huffman SL, Brady PG. Abnormalities of hepatic mitochondrial urea-cycle enzyme activities and hepatic ultrastructure in acute fatty liver of pregnancy. J Lab Clin Med 1979;94:27–41.

    PubMed  CAS  Google Scholar 

  54. Partin JC. Reye’s syndrome (encephalopathy and fatty liver): Diagnosis and treatment. Gastroenterology 1975;69:511–518.

    PubMed  CAS  Google Scholar 

  55. de Vivo DC. How common is Reye’s syndrome? N Engl J Med 1983;309:179–181.

    Article  Google Scholar 

  56. Halpin TJ, Holtzhauer FJ, Campbell RJ et al. Reye’s syndrome and medication use. J Am Med Assoc 1982;248:687–691.

    Article  CAS  Google Scholar 

  57. Pande SV, Blanchaer MC. Reversible inhibition of mitochondrial adenosine diphosphate phosphorylation by long chain acyl coenzyme A esters. J Biol Chem 1971;246:402–411.

    PubMed  CAS  Google Scholar 

  58. Kang ES, Capaci MT, Korones DN, Tekade N. Liver coenzyme A ester content: comparison between Reye’s syndrome and control subjects. Clin Sci 1982;63:455–460.

    PubMed  CAS  Google Scholar 

  59. Kunelis CT, Peters RL, Edmondson HA. Fatty liver of pregnancy and its relationship to tetracycline therapy. Am J Med 1965;38:359–377.

    Article  PubMed  CAS  Google Scholar 

  60. Schiffer MA. Fatty liver associated with administration of tetracycline in pregnant and nonpregnant women. Am J Obstet Gynecol 1966;96:326–332.

    PubMed  CAS  Google Scholar 

  61. Zimmerman HJ, Ishak KG. Valproate-induced hepatic injury: Analysis of 23 fatal cases. Hepatology 1982;2:591–597.

    Article  PubMed  CAS  Google Scholar 

  62. Zanfrani ES, Berthelot P. Sodium valproate in the induction of unusual heaptotoxicity. Hepatology 1982;2:648–649.

    Article  Google Scholar 

  63. Bonnell HJ, Beckwith JB. Fatty liver in sudden childhood death. Implications for Reye’s syndrome? Am J Dis Child 1986;140:30–33.

    PubMed  CAS  Google Scholar 

  64. Hjelm M, de Silva LYK, Seakins JWT, Oberholzer VG. Evidence of inherited urea cycle defect in a case of fatal valproate toxicity. Br Med J 1986;292:23–24.

    Article  CAS  Google Scholar 

  65. Morgan MY, Sherlock S, Scheuer PJ. Acute cholestasis, hepatic failure and fatty liver in the alcoholic. Scand J Gastroenterol 1978;13:299–303.

    Article  PubMed  CAS  Google Scholar 

  66. Uchida T, Kao H, Quispe-Sjogren M et al. Alcoholic foamy degeneration: A pattern of acute alcoholic injury of the liver. Gastroenterology 1983;84:683–692.

    PubMed  CAS  Google Scholar 

  67. Histologic studies of severe delta agent infection in Venezuelan indians. Hepatology 1983;3:906–912.

    Google Scholar 

  68. Hadler SC, De Monzon M, Ponzetto A et al. Delta virus infection and severe hepatitis: An epidemic in the Yucpa indians of Venezuela. Ann Intern Med 1984;100:339–344.

    PubMed  CAS  Google Scholar 

  69. Bensebath G. Hepatite de Labrea (febre negra de Labrea) e outras hepatites fulminantes en Sena Madureira, Acre e Boca do. Inst Med Trop Sao Paulo 1983;25:182–194.

    Google Scholar 

  70. Buitrago B, Popper H, Hadler SC et al. Specific histologic features of Santa Marta hepatitis: a severe form of hepatitis delta virus infection in northern South America. Hepatology 1986; in press.

    Google Scholar 

  71. Ciain JE, Stephens DH, Charboneau JW. Ultrasonography and computed tomography in focal fatty liver. Gastroenterology 1984;87:948–952.

    Google Scholar 

  72. Brawer MK, Austin GE, Lewin KJ. Focal fatty change of the liver, a hitherto poorly recognized entity. Gastroenterology 1980;78:247–252.

    PubMed  CAS  Google Scholar 

  73. Mulhern CB Jr, Arger PH, Coleman BG, Stein GN. Non-uniform attenuation in computed tomography study of the cirrhotic liver. Radiology 1979;132:399–402.

    PubMed  Google Scholar 

  74. Yates CK, Streight RA. Focal fatty infiltration of the liver simulating metastatic disease. Radiology 1986;159:83–84.

    PubMed  CAS  Google Scholar 

  75. Alpern MB, Lawson TL, Foley WD et al. Focal hepatic masses and hepatic infiltration detected by enhanced dynamic CT. Radiology 1986;158:45–49.

    PubMed  CAS  Google Scholar 

  76. Swobodnik W, Wechsler JG, Manne W, Ditschuneit H. Multiple regular circumscript fatty infiltrations of the liver. J Clin Ultrasound 1985;13:577–580.

    Article  PubMed  CAS  Google Scholar 

  77. Flournoy JG, Potter JL, Sullivan BM, Gerza BM, Ramzy I. CT appearance of multifocal hepatic steatosis. J Comput Assist Tomogr 1984;8:1192–1194.

    Article  PubMed  CAS  Google Scholar 

  78. Patel S, Sandler CM, Rauschkolb EN, McConnell BJ. 131 Xe uptake in focal hepatic fat accumulation: CT correlation. Am J Roentgenol 1982;138:1192–1194.

    Google Scholar 

  79. Gale ME, Gerzof SG, Robbins AH. Portal architecture: A differential guide of fatty infiltration of the liver on computed tomography. Gastrointest Radiol 1983;8:231–236.

    Article  PubMed  CAS  Google Scholar 

  80. Marchai G, Tshibwabwa-Tumba E, Verbeken E et al. “Skip-areas” in hepatic steatosis: A sonographic-angiographic study. Gastrointest Radiol 1986;11:151–157.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Royal Free Hospital School of Medicine, NW3 2QG, London, England

    Sheila Sherlock

Authors
  1. Sheila Sherlock
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. University of Calgary, Calgary, Alberta, Canada

    Eldon Shaffer M.D.

  2. The University of Alberta, Edmonton, Alberta, Canada

    Alan B. R. Thomson M.D., Ph.D.

Rights and permissions

Reprints and permissions

Copyright information

© 1989 Plenum Publishing Corporation

About this chapter

Cite this chapter

Sherlock, S. (1989). The Clinician Looks at Fatty Liver. In: Shaffer, E., Thomson, A.B.R. (eds) Modern Concepts in Gastroenterology Volume 2. Topics in Gastroenterology. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-0781-5_1

Download citation

  • DOI: https://doi.org/10.1007/978-1-4613-0781-5_1

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4612-8079-8

  • Online ISBN: 978-1-4613-0781-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation