stomach, pancreas, or large intestine).
There are 2 main types of primary tumour:
a hepatoma, which develops in the liver
cells, and a cholangiocarcinoma, which
arises from cells lining the bile ducts.
The most common symptoms of any
liver cancer are loss of appetite, weight
loss, lethargy, and sometimes pain in the
upper right abdomen. The later stages of
the disease are marked by jaundiceand
ascites(excess fluid in the abdomen).
Tumours are often detected by ultrasound
scanning, and diagnosis may be con-
firmed by liver biopsy. A hepatoma can
sometimes be cured by complete re-
moval. In other cases, anticancer drugs
can help to slow the progress of the dis-
ease. It is usually not possible to cure
secondary liver cancer, but anticancer
drugs or, in some cases, removal of a
solitary metastasismay be advised.
liver, cirrhosis ofSee cirrhosis.
liver disease, alcoholicDamage to the
livercaused by excessive alcoholcon-
sumption. The longer consumption goes
on, the more severe the damage. The ini-
tial effect is the formation of fat globules
between liver cells, a condition called
fatty liver. This is followed by alcoholic
hepatitis, and damage then progresses to
cirrhosis. Alcohol-related liver disease
increases the risk of developing liver
cancer. Liver function testsshow a char-
acteristic pattern of abnormalities, and
liver biopsymay be needed to assess the
severity of damage. There is no particular
treatment, but abstinence from alcohol
prevents further damage. Treatment for
alcohol dependencemay be required.
liver, disorders ofThe liveris a com-
mon site of disease. The most significant
liver conditions include alcohol-related
disorders (see liver disease, alcoholic),
hepatitis, and liver cancer. Disorders can
also result from infection. Certain virus-
es cause hepatitis (see hepatitis, viral).
Bacteria may spread up the biliary sys-
tem to the liver, causing cholangitisor
liver abscess. Parasitic diseases affecting
the liver include schistosomiasis, liver
fluke, and hydatid disease. Certain meta-
bolic disorders, such as haemochromatosis
and Wilson’s disease, may involve the
liver. Other types of liver disorder include
Budd–Chiari syndrome, in which the veinsdraining the liver become blocked. Occa-
sionally, defects of liver structure are
present at birth. Such defects principally
affect the bile ducts; one example is bil-
iary atresia, in which thebile ducts are
absent. Because the liver breaks down
drugs and toxins, damage to liver cells
can also be caused through overdose or
drug allergy. (See also jaundice;liver
failure;portal hypertension.)
liver failureSevere impairment of liver
function that develops suddenly or at the
final stages of a chronic liver disease.
Because the liver breaks down toxins in
the blood, liver failure causes the levels
of the toxins to rise, affecting the function-
ing of other organs, particularly the brain.
Liver failure may be acute or chronic.
Symptoms of acute liver failure develop
rapidly and include impaired memory,
agitation, and confusion, followed by
drowsiness. The functioning of other
organs may become impaired, and the
condition may lead to comaand death.
Features of chronic liver failure develop
much more gradually and include jaun-
dice, itching, easy bruising and bleeding,
a swollen abdomen due to accumulated
fluid, red palms and, in males, gynaeco-
mastia(enlarged breasts) and shrunken
testes. Chronic liver failure may sudden-
ly deteriorate into acute liver failure.
Acute liver failure requires urgent hos-
pital care. Although no treatment can
repair damage that has already occurred
in acute and chronic liver failure, certain
measures, such as prescribing diuretic
drugsto reduce abdominal swelling, may
be taken to reduce the severity of symp-
toms. Consumption of alcohol should
cease in all cases. The prognoses for
sufferers of chronic liver failure vary
depending on the cause, but some peo-
ple survive for many years. For acute
liver failure, a liver transplantis neces-
sary to increase the chances of survival.
liver fluke Any of various species of flukes
(flatworms) that infest the bile ductsin
the liver. The only significant fluke in the
UK is FASCIOLA HEPATICA, which causes
the disease fascioliasis.
Fascioliasis has 2 stages. During the
first stage, young flukes migrate through
the liver, causing it to become tender
and enlarged; other symptoms includeLIVER, CIRRHOSIS OF LIVER FLUKEL