A patient with alcoholic liver disease may develop a cholestatic syndrome. Taking the patient to surgery for presumed large duct obstruction may be followed by hepatic and/or renal failure.
(1) right upper quadrant pain and tenderness
(4) recent excessive alcohol use (may be denied)
(1) elevated serum alkaline phosphatase
(2) elevated serum total bilirubin
(1) negative ultrasound for stones and obstruction
(2) negative ERCP
(3) negative transhepatic cholangiography
Liver biopsy findings:
(1) alcoholic steatohepatitis or cirrhosis
(2) bile plugs in canaliculi
(3) variable cholangitis
(4) negative for findings of large duct obstruction
Problems in diagnosis may occur if the patient also has:
(1) cholelithiasis OR
(1) viral hepatitis
(2) cholestatic drug reaction
(3) non-alcoholic steatohepatitis
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Purpose: To evaluate a patient with alcoholic liver disease for intrahepatic cholestasis.
Specialty: Gastroenterology, Toxicology
Objective: clinical diagnosis, including family history for genetics, imaging studies, severity, prognosis, stage
ICD-10: K70.9, K75.8,