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Occasionally, liver biopsy is required to monitor the progress of treatment, such as in chronic viral hepatitis. [1] It is an effective way to measure changes in the Ishak fibrosis score. [3] For the last century liver biopsy has been considered as the gold standard for assessing the stage and the grade of chronic liver disease.
Informed consent is obtained before the procedure. The main risks are bleeding and perforation. The risk is increased when a biopsy or other intervention is performed. The patient lies on their left side with the head resting comfortably on a pillow. A mouth-guard is placed between the teeth to prevent the patient from biting on the endoscope.
Side effects include bloating, nausea, or a sore throat for one to two days. Complications include pancreatitis, infection of the bile ducts or gallbladder, bleeding, reaction to the anesthesia, and perforation of any structures that the scope or its instruments pass but particularly the duodenum, bile duct, and pancreatic duct.
Esophageal inlet patches are diagnosed by upper endoscopy (esophagogastroduodenoscopy or EGD). Detection of esophageal inlet patches may be improved by the use of specialized imaging techniques such as narrow-band imaging (optical chromoendoscopy).
The diagnosis of portal hypertensive gastropathy is usually made on endoscopy. The usual appearance of portal hypertensive gastropathy on endoscopy is a mosaic-like or reticular pattern in the mucosa. Red spots may or may not be present. The pattern is usually seen throughout the stomach. [2]
Autoimmune hepatitis, formerly known as lupoid hepatitis, plasma cell hepatitis, or autoimmune chronic active hepatitis, is a chronic, autoimmune disease of the liver that occurs when the body's immune system attacks liver cells, causing the liver to be inflamed.
Some uses for this procedure includes: drainage of bile/infected bile to relieve obstructive jaundice, to place a stent to dilate a stricture in the biliary system, stone removal, and rendezvous technique [4] where guidewire from the common bile duct (CBD) meets with duodenoscope (coming from the oesophagus into the stomach and then duodenum) at the major duodenal papilla.
Doppler ultrasound of the liver is typically utilized to confirm or suggest the diagnosis. Common findings on liver doppler ultrasound include increased phasicity of portal veins with eventual development of portal flow reversal. The liver is usually enlarged but maintained normal echogenicity. A liver biopsy is required for a definitive diagnosis.