Hepatology is the branch of medicine that incorporates 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 specialising 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. One third of world population has been infected with Hepatitis B virus at some point in their life. Although most of them would clear the virus from the body, approximately 350 million have become persistent carriers. Up to 80% of liver cancers can be attributed to either hepatitis B or Hepatitis C virus. In terms of number of mortality, the former is second only to smoking among known agents causing cancer. Hopefully, widespread implementation of vaccination and strict screening before blood transfusion are going to lower the infection rate in future.
However in many countries overall alcohol intake is on the rise and as one can expect, number of people with cirrhosis and other related complications are increasing.
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
Damage to liver from other toxins like drugs. Paracetamol overdose is common
Cancer of above organs. Usually multi-disciplinary approach is under taken with involvement of oncologist and other experts.
Evidence from autopsies on Egyptian mummies suggest that liver damage from parasitic infection Bilharziasis was widespread in the ancient society.
It is possible that Greeks might be aware of liver's ability to exponentially duplicate as illustrated by Prometheus story. However knowledge about liver diseases in antiquity was some what sketchy. Most of the important advances in the field were made in last 50 years.
In 400 BC Hippocrates mentioned liver abscess in apporium .
Roman anatomistGalen thought liver is the principle organ of the body. He also identified its relationship with gallbladder and spleen.
Around 100CE Areteus of cappadoca wrote on jaundice
In mideaval period Avicenna noted the importance of urine in diagnosing liver conditions.
1770 French anatomist Antoine Portal, noted bleeding due to oesophageal varices,
1844 Gabriel Valentin showed pancreatic juices break down food in digestion.
1846 Justus Von Leibig discovered pancreatic juice tyrosine