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eFigure 18–1. Jaundice. (Reproduced, with permission, from Sherlock S, Summerfield JA. Color Atlas of Liver Disease. Mosby, 1991.) A photo shows a patient with yellow-colored skin and sclera.

Current Medical Diagnosis & Treatment 2025 > Jaundice & Evaluation of Abnormal Liver Biochemical Tests

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eFigure 18–2. Urine in hyperbilirubinemia. (Reproduced, with permission, from Sherlock S, Summerfield JA. Color Atlas of Liver Disease. Mosby, 1991.) A photo shows three urine samples, 1 through 3. The darkness of the yellow shade increases from 1 to 3.

Current Medical Diagnosis & Treatment 2025 > Jaundice & Evaluation of Abnormal Liver Biochemical Tests

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eFigure 18–3. Vascular spider telangiectasia. (Reproduced, with permission, from Sherlock S, Summerfield JA. Color Atlas of Liver Disease. Mosby, 1991.) A photo shows streaks of thin blood vessels originating from a point on the skin.

Current Medical Diagnosis & Treatment 2025 > Jaundice & Evaluation of Abnormal Liver Biochemical Tests

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eFigure 18–4. Palmar erythema. (Reproduced, with permission, from Sherlock S, Summerfield JA. Color Atlas of Liver Disease. Mosby, 1991.) A photo shows that the surface of the inner palm is reddened.

Current Medical Diagnosis & Treatment 2025 > Jaundice & Evaluation of Abnormal Liver Biochemical Tests

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eFigure 18–5. Caput medusae, umbilical hernia. (Reproduced, with permission, from Sherlock S, Summerfield JA. Color Atlas of Liver Disease. Mosby, 1991.) A photo shows a bulge in the umbilicus of a pot belly.

Current Medical Diagnosis & Treatment 2025 > Jaundice & Evaluation of Abnormal Liver Biochemical Tests

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eFigure 18–6. Ascites, gynecomastia. (Reproduced, with permission, from Sherlock S, Summerfield JA. Color Atlas of Liver Disease. Mosby, 1991.) A photo shows bulged abdomen of a patient.

Current Medical Diagnosis & Treatment 2025 > Jaundice & Evaluation of Abnormal Liver Biochemical Tests

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eFigure 18–10. Schematic diagram of a percutaneous transhepatic cholangiogram, here used to provide drainage for an obstructing pancreatic carcinoma. A: A dilated peripheral intrahepatic bile duct is entered percutaneously with a fine needle (arrow). B: A long guidewire is passed through the needle into the intrahepatic duct, common hepatic duct, and common bile duct, and then advanced past the tumor into the duodenum. C: The needle is withdrawn, and a plastic catheter has been passed over the guidewire to create a channel through the liver parenchyma. D: An external-internal drainage catheter is inserted over the guidewire and through the channel, then advanced via the bile ducts and through the tumor to empty into the duodenum. (Reproduced, with permission, from James TW, Baron TH. Endoscopic and Radiologic Treatment of Biliary Disease. In: Feldman M, Friedman LS, Brandt LJ [editors]. Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 2 vol set, 11th edition. Philadelphia, Elsevier; 2023.) Four diagrams of the liver and gall bladder depict the steps in a percutaneous transhepatic cholangiogram.

Current Medical Diagnosis & Treatment 2025 > Jaundice & Evaluation of Abnormal Liver Biochemical Tests

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Figure 18–1. The typical course of acute type A hepatitis. Anti-HAV, antibody to hepatitis A virus; HAV, hepatitis A virus. (Reproduced with permission from Koff RS. Acute viral hepatitis. In: Friedman LS, Keeffe EB. Handbook of Liver Disease, 4th ed. Philadelphia: Saunders Elsevier, 2018.) A graph shows a typical course of acute type A hepatitis.

Current Medical Diagnosis & Treatment 2025 > Acute Hepatitis A

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Figure 18–2. The typical course of acute type B hepatitis. Anti-HBe, antibody to HBeAg; anti-HBc, antibody to hepatitis B core antigen; anti-HBs, antibody to HBsAg; HBeAg, hepatitis Be antigen; HBsAg, hepatitis B surface antigen. (Reproduced with permission from Koff RS. Acute viral hepatitis. In: Friedman LS, Keeffe EB. Handbook of Liver Disease, 3rd ed. Philadelphia: Saunders Elsevier, 2012.) A graph shows a typical course of acute type B hepatitis.

Current Medical Diagnosis & Treatment 2025 > Acute Hepatitis B

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eFigure 18–21. Spider telangiectasias of the thoracic wall in chronic liver disease. The small dilated blood vessels seen in patients with liver disease are called spider telangiectasias because they tend to radiate outward resembling a spider's web. (Used, with permission, from Neil Mehta, MD.) A photo shows streaks of blood vessels originating from a point on the skin.

Current Medical Diagnosis & Treatment 2025 > Cirrhosis

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eFigure 18–35. Tendinous xanthomas. (Reproduced, with permission, Sherlock S, Summerfield JA. Color Atlas of Liver Disease. Mosby, 1991.) A photo shows nodules in the palms of a patient.

Current Medical Diagnosis & Treatment 2025 > Primary Biliary Cholangitis

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eFigure 18–51. Cholangiogram shows multiple bile duct stones (arrows). (Reproduced, with permission, from Wang D Q.-H, Afdhal NH. Gallstone Disease. In: Feldman M, Friedman LS, Brandt LJ [editors]. Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 2 vol set, 11th edition. Philadelphia, Elsevier; 2023.) A cholangiogram shows a magnified view of the tubular vertical bile duct with three black stones inside its distal end, indicated by arrows.

Current Medical Diagnosis & Treatment 2025 > Choledocholithiasis & Cholangitis

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eFigure 18–52. Endoscopic sphincterotomy. (Reproduced, with permission, from James TW, Baron TH. Endoscopic and Radiologic Treatment of Biliary Disease. In: Feldman M, Friedman LS, Brandt LJ [editors]. Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 2 vol set, 11th edition. Philadelphia, Elsevier; 2023.) Two endoscopic images show the procedure of sphincterotomy.

Current Medical Diagnosis & Treatment 2025 > Choledocholithiasis & Cholangitis

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eFigure 18–53. Liver biopsy specimens showing two views of the characteristic periductal fibrosis (“onion-skinning”) of sclerosing cholangitis. (Reproduced, with permission, from Levy C, Bowlus CL. Primary and Secondary Sclerosing Cholangitis. In: Feldman M, Friedman LS, Brandt LJ [editors]. Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 2 vol set, 11th edition. Philadelphia, Elsevier; 2023.) Two micrographs show the histology of periductal fibrosis.

Current Medical Diagnosis & Treatment 2025 > Primary Sclerosing Cholangitis

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eFigure 18–54. Endoscopic retrograde cholangiopancreatography shows sclerosing cholangitis (metallic clips shown are incidental). (Reproduced, with permission, from Levy C, Bowlus CL. Primary and Secondary Sclerosing Cholangitis. In: Feldman M, Friedman LS, Brandt LJ [editors]. Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 2 vol set, 11th edition. Philadelphia, Elsevier; 2023.) An angiogram shows a white branching tubular duct with several oval masses clustered along the branches.

Current Medical Diagnosis & Treatment 2025 > Primary Sclerosing Cholangitis

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