Friday, November 21, 2014

Definition

Fatty liver is the accumulation of fat in liver cells. It is also called steatosis.

Description

Possible explanations of fatty liver include the transfer of fat from other parts of the body or an increase in the extraction of fat presented to the liver from the intestine. Other explanations are that the liver reduces the rate it breaks down and removes fat. Eating fatty foods does not by itself produce a fatty liver.

Causes

Alcohol, obesity, starvation, diabetes mellitus, corticosteroids, poisons (carbon tetrachloride and yellow phosphorus), Cushing's syndrome, and hyperlipidemia are some causes of fatty liver. Microvesicular fatty liver may be caused by valproic acid toxicity and high-dose tetracycline or during pregnancy.

Symptoms

Patients are often asymptomatic.

Diagnosis

The patient may have an enlarged liver or minor elevation of liver enzyme tests. Several studies show that fatty liver is one of the most common causes of isolated minor elevation of liver enzymes found in routine blood screening.

Images of the liver obtained by an ultrasound test, CT (computed tomography) scan, or MRI (magnetic resonance imaging) may suggest the presence of a fatty liver. To be certain whether a patient has fatty liver requires a liver biopsy, in which a small sample of liver tissue is obtained through the skin and analyzed under the microscope.

Treatment

The treatment of fatty liver is related to the cause. It is important to remember that simple fatty liver may not require treatment. The benefit of weight loss, dietary fat restriction, and exercise in obese patients is inconsistent.

Reducing or eliminating alcohol use can improve fatty liver due to alcohol toxicity. Controlling blood sugar may reduce the severity of fatty liver in patients with diabetes. Ursodeoxycholic acid may improve liver function test results, but its effect on improving the underlying liver abnormality is unclear.

Questions

Is there fatty infiltration of the liver?

What did the liver function test show?

Is this related to diabetes mellitus?

Is it related to any other medical problem?

Should alcohol consumption be curtailed?

What treatment, if any, do you recommend?