Mayo 2018
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Which Patients With Fatty Liver Disease On Ultrasound Require A Liver Biopsy?

(A) An algorithm for diagnosis in patients with persistent normal liver enzymes who present with either hepatomegaly or imaging abnormalities. (B) An algorithm for diagnosis in patients with elevated liver enzymes

Rarely, other more serious complications such as pneumothorax, hemothorax, and bile peritonitis occur, requiring more intensive monitoring and evaluation. At the Mayo clinic, 9212 liver biopsies were performed with data prospectively recorded to identify risk factors for major bleeding. There were 10 fatal and 22 nonfatal hemorrhages (0.11% and 0.24%, respectively). When compared to those patients who did not experience a hemorrhage, malignancy, age, sex, and the number of passes were the only predictable risk factors for an adverse event.2 Approach to Subject With an Echogenic Liver3 The need for a liver biopsy is often dictated by the clinical scenario in which the sonographic findings are discovered. In subjects with elevated liver enzymes, it is imperative to first exclude other common causes of liver enzyme elevation and to obtain a good history with respect to alcohol consumption. Subjects who consume more than 2 or 3 alcoholic beverages daily or those who binge drink (eg, a 6-pack of beer on the weekend) should be counseled to stop drinking and should be reassessed after at least 3months of abstinence. In subjects with persistently elevated liver enzymes, it is known that 25% to 30% of subjects do not have NAFLD. In fact, 5% to 7% of such cases have normal liver histology. Given the frequent coexistence of NAFLD and features of the metabolic syndrome, it appears logical that if such features are present, then the likelihood of having fatty liver disease is higher.

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Obesity Causing Fatty Liver Disease In Children

Its fatty liver disease, and in kids, its from obesity. One in 10 children is believed to have the condition. About four in 10 obese kids have it. Something Dr. Dale King, a pediatric gastroenterologist at Childrens Hospital of Pittsburgh, sees more and more of these days. The thing that I find frightening about fatty liver is the unknowns, says Dr.

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