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Diagnostic Tests for Liver symptoms

Diagnostic Test list for Liver symptoms:

The list of diagnostic tests mentioned in various sources as used in the diagnosis of Liver symptoms includes:

  • General appearance
    • General appearance - looking for jaundice (yellowing of the skin and sclera of the eyes), signs of recent weight loss, physical distress.
  • Physical examination
    • Inspect the abdomen for generalized distension which may indicate ascites (collection of fluid in the abdominal cavity). If ascites is associated with tender liver may indicate Budd-Chiari syndrome (hepatic vein thrombosis) or right heart failure
    • Palpate the liver - to assess liver tenderness, size of the liver, to detect liver pulsatility and to feel the liver edge. A tender liver may be due to hepatitis, rapid liver enlargement (due to right heart failure or Budd-Chiari syndrome), hepatocellular cancer, ascending cholangitis or hepatic abscess. A pulsatile liver that is also tender would suggest hepatocellular cancer. If there is jaundice but little or no enlargement of the liver this would suggest hemolytic anemia, Gilbert's disease , pernicious anemia and Dubin-Johnson syndrome.
    • Palpate for enlarged spleen. If both liver and spleen is enlarged may suggest alcoholic cirrhosis, amyloidosis, reticuloendotheliosis, hemolytic anemias, biliary cirrhosis, myeloid metaplasia, systemic lupus erythematosus, acute viral hepatitis, infectious mononucleosis, cytomegalovirus and various parasitic diseases. If the spleen enlargement is massive this is characteristic of Gaucher's disease, kala azar and myeloid metaplasia
    • Palpate for enlarged gallbladder. If enlarged gallbladder with enlarged liver and jaundice may suggest bile duct obstruction due to cancer of the pancreas, bile ducts or ampulla of Vater
    • Palpate for any other abdominal mass which may suggest metastatic cancer
    • Examine the lungs and heart system
    • Inspect for generalized enlarged lymph nodes which may suggest lymphoma
    • Inspect for other signs of alcoholic liver disease including bruising, jaundice, scratch marks, reddened palms, enlarged breasts in males, loss of body hair, enlarged spleen, swollen legs and abdomen
    • Inspect for other signs of right heart failure including distended neck veins, swelling of the ankles, abdominal ascites (fluid accumulation in the abdominal cavity) and pleural fluid (fluid accumulation in the lung cavity)
  • Blood tests
    • Full blood count and ESR (can detect signs of leukemia and lymphoma; look for increased eosinophils with hydatid disease)
    • Reticulocyte count and red cell fragility test
    • Liver function tests with bilirubin
    • Electrolytes and kidney function tests
    • Fasting blood sugar
    • Viral serology for Hepatitis A, B and C
    • ANA and smooth muscle autoantibodies to diagnose systemic lupus erythematosus
    • Monospot test for infectious mononucleosis (Epstein Barr virus test)
    • Cytomegalovirus antibodies
    • Leptospirosis serology
    • Mitochondrial antibodies, if suspect primary biliary cirrhosis
    • HIV serology, if indicated
    • Iron studies, to diagnose hemochromatosis
    • Copper and caeruloplasmin test, if suspect Wilson's disease
    • Blood smear, sickle cell preparation, serum Haptoglobin and hemoglobin electrophoresis, if suspect hemolytic anemia
    • Alpha 1-fetoprotein, if suspect primary liver cancer
    • Hydatid antibodies, if suspect hydatid disease
    • Blood cultures- if there are chills and fever
    • Amoebic fluorescent antibody titre (FAT) is positive in at least 90% of people with liver abscesses due to Entamoeba
  • Urine tests
    • Urine analysis and microscopy - Look for Bilirubin present in jaundice.
  • Radiological investigations
    • Chest X-Ray (looking for enlarged heart, metastases)
    • Liver ultrasound scan may detect the cause of the liver enlargement - e.g. metastases, liver cancer, fatty liver, hydatid disease, liver abscess, Budd-Chiari syndrome.
    • CT scan of abdomen will help in the diagnosis of metastatic carcinoma and often find the source of the primary tumor and will further delineate any findings found on ultrasound
    • Radioisotope scan of liver will show a filling defect of hepatocellular cancer
    • Gallbladder ultrasound, if suspect cholecystitis or gallstones
    • Hepatic venography may demonstrate the obstructed vein in Budd-Chiari syndrome (hepatic vein thrombosis)
    • Chest X-ray for evidence of right ventricular heart failure
    • Echocardiogram and cardiac catheterization may be required to assess valvular disease, if suspect right heart failure
  • Tuberculin sensitivity skin testing (Mantoux test) - for tuberculosis.
  • ECG
  • Liver biopsy - may help diagnose metastatic carcinoma, primary liver cancer, hemochromatosis, reticuloendotheliosis and the various types of cirrhosis (but do not perform if suspect biliary cirrhosis as it is dangerous).
  • Endoscopic retrograde cholangiopancreatography (ERCP) - may need to be done to investigate bile duct obstruction.
  • Exploratory surgery - may be the only way of obtaining a diagnosis.

Home Diagnostic Testing

These home medical tests may be relevant to Liver symptoms causes:

Conditions listing medical symptoms: Liver symptoms:

The following list of conditions have 'Liver symptoms' or similar listed as a symptom in our database. This computer-generated list may be inaccurate or incomplete. Always seek prompt professional medical advice about the cause of any symptom.

Select from the following alphabetical view of conditions which include a symptom of Liver symptoms or choose View All.

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Conditions listing medical complications: Liver symptoms:

The following list of medical conditions have 'Liver symptoms' or similar listed as a medical complication in our database.

 

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