Diagnostics and study of the liver

Functional diagnostics. Violations of the liver revealed with the help of complex samples, reflecting the different functions of the liver.
The study pigmentary exchange. The determination of bilirubin concentration in blood serum (see Bilirubinemia) enables to establish the presence of jaundice (see) and its degree. There are many different methods of determination of bilirubin (see Ehrlich desireable). When mechanical (obstructive) jaundice level conjugated bilirubin in the blood reaches the highest figures in the lung (hepatic) - moderate numbers, hemolytic (nadrechenskaya) its level is low. In urine bilirubin appears when parenchymatous and mechanical jaundice (see Bilirubinuria).
When mechanical jaundice there is a lack of bilirubin in the duodenal contents. When events hemolysis (pernicious anemia, hemolytic anemia) the content of bilirubin in the duodenal contents significantly increased. Stercobilin in Calais not if the obstruction of the common bile duct. Qualitative method of determining stercobilin in Calais - see Cal. The urobilin missing in urine at full mechanical jaundice and elevated content indicates excessive hemolysis. Methods for determination of urobilin - see Urine, Urobilinemia.
The study of protein metabolism is necessary for the evaluation of protein in liver function. In addition to the determination of total protein of serum blood, apply electrophoretic analysis (see Electrophoresis), establishing relationships of the individual protein fractions. Hyperproteinemia observed in chronic hepatitis, hypoproteinemia - in portal cirrhosis of the liver. On the state of protein in the blood can indirectly judge also in so-called sedimentary sample - sublimate (see Sublimate the sample) and thymol (see Thymol test)that it is expedient to apply in complex with electrophoretic research.
For research of excretory functions of the liver offer various samples with a load of substances that are excreted in the bile. The most specific one is bromsulfaleinovy the sample, since the liver is a main organ, absorbing the paint from the blood. OK after 45 minutes in the blood circulates less than 5% of the dye injected. When liver damage they stay in the blood for longer terms.
Antitoxic (decontaminating) liver function is estimated using a sample of Quick - Pytel. Determine the number of allocated with the urine hippuric acid after ingestion benthological sodium. In norm with the introduction of per os 4 g benthological sodium for 4 hours is not less than 3 g (80% or more) of hippuric acid. As acute conditions and acute exacerbation of chronic liver synthesis of the hippuric acid is reduced.
The study of carbohydrate metabolism is done usually by means of loading tests with galactose. Administered per os 40 grams of galactose in 250 ml of water and collect urine every hour for 6 hours, seventh serving for the rest of the day. All portions determine the amount of sugar and count on galactose. In the norm there are not more than 3 grams of galactose.
Research activity of enzymes of blood are not strictly specific to liver disease, but may not be objective test for judgments about the effectiveness of the treatment of liver diseases. The most common methods are to determine transaminaz, aldolase and alkaline phosphatase. Taking blood from a vein to identify all of the above functional studies of the liver produce on an empty stomach.
Needle biopsy of the liver may be blind - needle Mangini the dotted line in the liver in the IX intercostal space on the right anterior axillary line (see Biopsy) and a sight - under the control of a laparoscope (see Peritoneoscope). Both manipulation produced in the dressing room, with observance of all rules of aseptics (see), antiseptics (see). In the subsequent histological processing of the drug can establish changes in the structure of the liver, characteristic of inflammatory and dystrophic processes.
Radioisotope study of the liver produce using compounds labeled with radioactive isotopes of iodine I131 or I125. This method allows to judge about the absorption and excretion of liver function is impaired, for example, in case of hepatitis. Method of scanning (see) has gained great importance in the diagnosis of liver disease. It allows you to set diffuse or focal lesions of the liver - metastatic tumors (see Radioisotope diagnostics).
X-ray examination of the liver is made by means of direct, side and layered images of the liver that can determine its position, size, shape, and the concrements, areas of calcification, an accumulation of gas within the liver or on its surface. For the purpose of diagnosis of liver applies pneumoperitoneum (see). X-ray examination of the esophagus and stomach can detect varicose veins submucosal their layer that is important and liver cirrhosis.