Hepatology

The medical department of Hepatology deals with the dysfunctions and diseases of the liver. The term hepar is the Greek name for the organ that fulfills numerous important tasks in metabolism, blood formation and detoxification of the organism.

What is the hepatology?

Hepatology is a branch of gastroenterology. The function of the liver cannot be viewed in isolation. It is an important factor for the healthy functioning of the digestive organs and the entire metabolism. Gastroenterology deals with the digestive system from the stomach to the liver and gall bladder to the individual sections of the intestine.

The hepatology department takes care of the physiology of the liver and the diagnosis and treatment of malformations and diseases of the liver, gall bladder and biliary tract. The liver is the largest metabolic organ. It has to produce the body's own proteins from foreign proteins. It produces the bile and other enzymes and messenger substances for the digestive process. It utilizes food components, stores vitamins and detoxifies the organism. The liver has a particularly strong ability to regenerate.

The digestive gland in an adult weighs around 1,500 grams. The structure of the liver consists of four different lobes anatomically and eight different liver segments functionally. The structure of the liver tissue shows up with many liver lobules. These are the actual functional tissue for controlling the glucose, fat and protein metabolism. The cells in the liver are called hepatocytes.

The digestive gland also contains the intrahepatic bile ducts, which direct the bile into the gallbladder. In addition, the liver tissue is interspersed with periportal fields, which consist of connective tissue. Important blood vessels run within the structure of the liver.

Treatments & therapies

Many diseases can damage liver tissue and the functioning of the digestive gland. The most common causes of liver damage are infections caused by viruses. The various forms of jaundice (hepatitis) should be considered here.

Bacteria can also cause liver infections. There are also parasites that damage liver tissue and cause abscesses. Parasites include canine and fox tapeworm, liver fluke and amoeba. Hepatology also includes inflammation of the liver, which is caused by an autoimmune process. In autoimmune diseases, the immune system attacks the body's own tissues and structures and fights them.

Another area of ​​hepatology is the diseases and disorders of the bile. Acute and chronic inflammation of the gallbladder is often caused by stone formation. Alcohol abuse and the use of certain medications can lead to fatty liver disease and even liver cirrhosis. Severe inflammation and toxins damage liver tissue. The liver cells are no longer able to carry out their extensive tasks. Liver failure occurs.

The areas of hepatology also include the diagnosis and therapy of malignant cell changes in liver tissue. The most common cause of tumors in the liver are cancers of the breast, bowel, prostate and other cancerous tumor diseases. In addition to the primary tumor, metastases can form anywhere in the body. The liver is particularly often affected by metastases. However, there are also cancers that originate in the liver. These include hepatocellular carcinoma and hepatoblastoma. Carcinomas can also form in the bile ducts.

Hepatology includes metabolic disorders that are caused by the functioning of the liver. These are relatively rare diseases such as Wilson's disease (copper storage disease), hemochromatosis (iron storage disease) and porphyrias (disruption in the production of red blood pigment). Without a functioning liver, humans cannot survive. The functions of the liver cannot be taken over by other organs. Even if the liver tissue can regenerate surprisingly well, there are cases in which this is no longer possible. The hepatology department then tries to enable the patient to survive through a liver transplant.

Diagnosis & examination methods

There are various options available to hepatology to make a diagnosis and to support it with laboratory results and imaging procedures. Important liver-specific laboratory values ​​can be determined in the blood and urine. These include direct and indirect bilirubin and liver enzymes such as AST, ALT, and GLDH. If the liver is damaged, the enzyme values ​​change and indicate inflammation. The synthesis capacity of the liver can be assessed if deviations from the normal value can be measured when checking the Quick value or the proportion of the protein albumin formed in the liver.

Changes in the levels of liver enzymes such as γ-GT and AP indicate an inflammatory process in the bile. The changed amount of iron or copper in the blood indicates a pathological iron and copper metabolism, which is controlled by the liver. In addition to laboratory values, imaging methods such as ultrasound, computed tomography (CT) and magnetic resonance imaging (MRT) are important examination methods for making a diagnosis.

The examination of the liver with a fibroscan is new. The elasticity of the liver tissue is measured. If cirrhosis of the liver has already developed, the liver is riddled with functionless connective tissue. The more this process has progressed, the more hardened the liver is. The examination is mainly carried out in the clinics. A liver biopsy is performed, especially if there is a suspicion of malignant tissue changes. During this invasive procedure, liver tissue is removed and then examined for any cancer cells that may be present.

Typical & common liver diseases

• Liver failure
• Cholestasis
• Liver cyst