Symptoms and Signs

Fatty Liver

Patients with FL are usually well. Hepatomegaly on examination may be the only sign of liver disease found [1].

Alcoholic hepatitis

Patients suffering from AH often look unwell with pyrexia. They can be jaundiced and show cutaneous signs of chronic liver damage (Fig 1). Tender hepatomegaly is found on palpation. Ascites and encephalopathy can develop but varices are rare, although bleeding may arise from gastric erosions exacerbated by coagulopathy [1].

Alcoholic cirrhosis

Features of AC include spider naevi, enlarged parotid glands, gynaecomastia, ascites, splenomegaly, palmar erythema, peripheral neuropathy and testicular atrophy [1,5]. Portal blood flow together with hepatic vascular resistance are both increased secondary to alcohol consumption, which increases portal pressure and collateral blood flow, thus increasing the risk of variceal bleeding in patients with alcoholic cirrhosis and increased portal hypertension [1].

Learning Bite

Clinical signs of liver disease may be subtle even with significant pathology.