WordNet

the branch of medicine that studies the gastrointestinal tract and its diseases

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/08/19 13:50:05」(JST)

wiki en

[Wiki en表示]

For the journal, see Hepatology (journal).

Not to be confused with heptalogy.

Fluoroscopic image of common bile duct

Hepatology is the branch of medicine that incorporates the study of liver, gallbladder, biliary tree, and pancreas as well as management of their disorders. Etymologically the word Hepatology is formed of ancient Greek hepar(ηπαρ) or hepato-(ηπατο-) meaning 'liver' and suffix -logia(-λογια) meaning 'word' or 'speech'. Although traditionally considered a sub-specialty of gastroenterology, rapid expansion has led in some countries to doctors specializing solely on this area, who are called hepatologists.

Diseases and complications related to viral hepatitis and alcohol are the main reason for seeking specialist advice. More than 2 billion people have been infected with Hepatitis B virus at some point in their life, and approximately 350 million have become persistent carriers.^[1] Up to 80% of liver cancers can be attributed to either hepatitis B or Hepatitis C virus. In terms of mortality, the former is second only to smoking among known agents causing cancer. With more widespread implementation of vaccination and strict screening before blood transfusion, lower infection rates are expected in the future. In many countries, though, overall alcohol consumption is increasing, and consequently the number of people with cirrhosis and other related complications is commensurately increasing.^{[citation needed]}

Schematic diagram of Hepato-biliary system

Scope of specialty[edit source | edit]

As for many medical specialties, patients are most likely to be referred by family physicians ( i.e., GP) or by physicians from different disciplines. The reasons might be:

Drug overdose. Paracetamol overdose is common.
Gastrointestinal bleeding from portal hypertension related to liver damage
Abnormal blood test suggesting liver disease
Enzyme defects leading to bigger liver in children commonly named storage disease of liver
Jaundice / Hepatitis virus positivity in blood, perhaps discovered on screening blood tests
Ascites or swelling of abdomen from fluid accumulation, commonly due to liver disease but can be from other diseases like heart failure
All patients with advanced liver disease e.g. cirrhosis should be under specialist care
To undergo ERCP for diagnosing diseases of biliary tree or their management
Fever with other features suggestive of infection involving mentioned organs. Some exotic tropical diseases like hydatid cyst, kala-azar or schistosomiasis may be suspected. Microbiologists would be involved as well
Systemic diseases affecting liver and biliary tree e.g. haemochromatosis
Follow up of liver transplant
Pancreatitis - commonly due to alcohol or gall stone
Cancer of above organs. Usually multi-disciplinary approach is undertaken with involvement of oncologist and other experts.

History[edit source | edit]

Dr. B Blumberg, Awarded Nobel prize 1976 for discovery of Hepatitis B virus

Evidence from autopsies on Egyptian mummies suggest that liver damage from parasitic infection Bilharziasis was widespread in the ancient society.^[2] It is possible that the Greeks may have been aware of the liver's ability to exponentially duplicate as illustrated by the story of Prometheus. However, knowledge about liver disease in antiquity is questionable. Most of the important advances in the field have been made in the last 50 years.

In 400 BC Hippocrates mentioned liver abscess in Aphorisms. ^[3]
Roman anatomist Galen thought the liver was the principle organ of the body. He also identified its relationship with the gallbladder and spleen.^[4]
Around 100CE Areteus of cappadoca wrote on jaundice^[5]
In medieval period Avicenna noted the importance of urine in diagnosing liver conditions.
1770 French anatomist Antoine Portal noted bleeding due to oesophageal varices,^[6]
1844 Gabriel Valentin showed pancreatic juices break down food in digestion.
1846 Justus Von Leibig discovered pancreatic juice tyrosine^[5]
1862 Austin Flint described the production of "stercorin".
1875 Victor Charles Hanot described cirrhotic jaundice and other diseases of liver^[7]
In 1958, Moore developed a standard technique for canine orthotopic liver transplantation.^[8]
The first human liver transplant was performed in 1963 by Dr. Thomas E. Starzl on a 3-year-old male afflicted with biliary atresia after perfecting the technique on canine livers.,^[9]^[10]
Baruch S. Blumberg discovered Hepatitis B virus in 1966 and developed first vaccine against it 1969. He was awarded the Nobel Prize in Physiology or Medicine 1976.^[11]
In 1989, investigators from the CDC (Daniel Bradley) and Chiron (Michael Houghton) identified the hepatitis C virus, which had previously been known as non-A, non-B hepatitis and could not be detected in the blood supply.^[12]
Only in 1992 was a blood test created that could detect hepatitis C in donated blood.^[13]

Disease classification[edit source | edit]

1. International Classification of Disease (ICD 2007)/ WHO classification:

Chapter XI: Diseases of the digestive system [1]
- K70-K77 Diseases of liver
- K80-K87 Disorders of gallbladder, biliary tract and pancreas

2. MeSH (medical subject heading):

G02.403.776.409.405 same as "Gastroenterology"
C06.552 Liver Diseases
C06.130 Biliary Tract Diseases
C06.689 Pancreatic diseases

3.National Library of Medicine Catalogue (NLM classification 2007):

WI 700-740 Liver and biliary tree Diseases
WI 800-830 Pancrease

Also see Hepato-biliary diseases

Important procedures[edit source | edit]

Endoscopic retrograde cholangiopancreatography(ERCP)
Transhepatic pancreato-cholangiography(TPC)
Transjugular intrahepatic portosystemic shunt(TIPSS)

Publication[edit source | edit]

Annals of Gastroenterology & Hepatology (AGH)
The American Journal of Gastroenterology (Journal of the American College of Gastroenterology)
The American Journal of Physiology - Gastrointestinal and Liver Physiology
Archives of Gastroenterohepatology
Comparative Hepatology
Current Hepatitis Reports
European Journal of Gastroenterology and Hepatology
Gastroenterología y Hepatología
Gastroenterology (journal of the American Gastroenterological Association)
Hepatobiliary & pancreatic diseases international : HBPD INT (First Affiliated Hospital, Zhejiang University School of Medicine, China)
Hepatology (journal of the American Association for the Study of Liver Diseases)
HPB
Journal of Gastroenterology and Hepatology
HPB Surgery
Journal of Hepato-Biliary-Pancreatic Surgery
Journal of Hepatology (journal of the European Association for the Study of Liver Diseases)
Journal of Viral Hepatitis
Liver
Liver Transplantation (from the American Association for the Study of Liver Diseases)
Nature clinical practice. Gastroenterology & hepatology.

Societies[edit source | edit]

American Association for the Study of Liver Disease
American College of Gastroenterology
American Gastroenterological Association
American Hepato-Pancreato-Biliary Association
American Liver Society
Asian Pacific Association for the Study of the Liver
Austrian Society of Gastroenterology and Hepatology
British Association for the Study of the Liver
British Society of Paediatric Gastroenterology, Hepatology and Nutrition
Canadian Association for the Study of the Liver
Canadian Liver Foundation

Czech Society of Hepatology

Danish Association for the Study of the Liver
European Association for the Study of the Liver
European Society of Paediatric Gastroenterology, Hepatology and Nutrition
French Association for the Study of the Liver
International Hepato-Pancreato-Biliary Association
International Liver Transplantation Society
Israel Association for the Study of the Liver
North American Society for Pediatric Gastroenterology, Hepatology and Nutrition
Society for Surgery of the Alimentary Tract
Spanish Society of Pediatric Gastroenterology, Hepatology and Nutrition
Swiss Association for the Study of the Liver
Turkish Association for the Study of the Liver

References[edit source | edit]

^ "WHO | Hepatitis B". Retrieved 2010-03-17.
^ Rosalie David A, Contis G (1996). "Paleopathology on schistosomiasis in Egyptian mummies". Parasitol. Today (Regul. Ed.) 12 (4): 167. doi:10.1016/0169-4758(96)80811-8. PMID 15275234.
^ http://classics.mit.edu/Hippocrates/aphorisms.mb.txt
^ "History of Liver, Gallbladder, and Spleen". Retrieved 2007-05-18.
^ ^a ^b H S.J. Lee (Editor) (1999). Dates in Gastroenterology: A Chronological Record of Progress in Gastroenterology over the Last Millennium (Landmarks in Medicine). Informa Healthcare. ISBN 1-85070-502-X.
^ Moodley J, Singh B, Lalloo S, Pershad S, Robbs JV (2001). "Non-operative management of haemobilia". The British journal of surgery 88 (8): 1073–6. doi:10.1046/j.0007-1323.2001.01825.x. PMID 11488792.
^ "Victor Charles Hanot (www.whonamedit.com)". Retrieved 2007-05-18.
^ "eMedicine - History of Pediatric Liver Transplantation : Article by Beth A Carter, MD". Retrieved 2007-05-18.
^ "History of Liver Transplantation". Retrieved 2009-09-08. ^{[dead link]}
^ STARZL TE, MARCHIORO TL, VONKAULLA KN, HERMANN G, BRITTAIN RS, WADDELL WR (1963). "Homotransplantation Of The Liver In Humans". Surgery, gynecology & obstetrics 117: 659–76. PMC 2634660. PMID 14100514.
^ "Baruch S. Blumberg - Autobiography". Retrieved 2007-05-18.
^ http://www.hcvadvocate.org/hepatitis/factsheets_pdf/Brief_History_HCV_10.pdf
^ http://www.hcvadvocate.org/hepatitis/factsheets_pdf/Brief_History_HCV_10.pdf

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 消化器学および肝臓学の最新情報 whats new in gastroenterology and hepatology
2. 薬物性肝障害 drug induced liver injury
3. 周期性嘔吐症候群 cyclic vomiting syndrome
4. 小児におけるセリアック病の診断 diagnosis of celiac disease in children
5. 小児および思春期の慢性腹痛：評価のためのアプローチ chronic abdominal pain in children and adolescents approach to the evaluation

English Journal

Traditional Herbal Medicine, Rikkunshito, Induces HSP60 and Enhances Cytoprotection of Small Intestinal Mucosal Cells as a Nontoxic Chaperone Inducer.

Tamaki K, Otaka M, Shibuya T, Sakamoto N, Yamamoto S, Odashima M, Itoh H, Watanabe S.SourceDepartment of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421, Japan.
Evidence-based complementary and alternative medicine : eCAM.Evid Based Complement Alternat Med.2012;2012:278958. Epub 2011 Jul 21.
Increasing incidence of small intestinal ulcers associated with nonsteroidal anti-inflammatory drugs (NSAIDs) has become a topic with recent advances of endoscopic technology. However, the pathogenesis and therapy are not fully understood. The aim of this study is to examine the effect of Rikkunshit
PMID 21822440

Prevention of Post-ERCP Pancreatitis.

Donnellan F, Byrne MF.SourceDepartment of Gastroenterology, Division of Medicine, Vancouver General Hospital, Vancouver, BC, Canada V5Z 1M9.
Gastroenterology research and practice.Gastroenterol Res Pract.2012;2012:796751. Epub 2011 Aug 10.
Pancreatitis is the most common complication of ERCP. It can be associated with substantial morbidity. Hence, the minimization of both the incidence and severity of post-ERCP pancreatitis is paramount. Considerable efforts have been made to identify factors that may be associated with an increased r
PMID 21845187

Japanese Journal

Molecular mechanisms of hepatocarcinogenesis in chronic hepatitis C virus infection

Yamashita Taro,Honda Masao,Kaneko Shuichi
Journal of Gastroenterology and Hepatology
… 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd. …
NAID 120003141912

消化管炎症マーカーと過敏性腸症候群(シンポジウム:脳腸相関と腸管炎症,2010年,第51回日本心身医学会総会ならびに学術講演会(仙台))

千葉俊美,佐藤邦彦,松田望,鳥谷洋右,遠藤啓,織笠俊輔,小坂崇,斎藤慎二,安孫子幸人,春日井聡,小穴修平,遠藤昌樹,鈴木一幸
心身医学 51(4), 312-316, 2011-04-01
目的:過敏性腸症候群(IBS)患者のサイトカインの動態をpolycarbophil calcium投与前後において比較検討した.対象:RomeIII基準を用いて診断したIBS患者24例を対象とした.その内訳は下痢型13例(男性7例,女性6例),便秘型11例(男性2例,女性9例),平均年齢55歳(25?74歳)であった.方法:Polycarbophil calcium(1500?3000mg/日)を …
NAID 110008593579