Metabolic dysfunction-associated steatohepatitis (MASH): Difference between revisions
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==Background== | ==Background== | ||
*Formerly known as [[non-alcoholic steatohepatitis]] | |||
[[File:Stage of liver damage high.jpg|thumb|Stages of non-alcoholic fatty liver disease, progressing from healthy, to steatosis (fat accumulation), inflammation, fibrosis and cirrhosis.]] | |||
[[File:Sobo 1906 389.png|thumb|Inferior view of the liver with surface showing lobes and impressions.]] | |||
[[File:Liver vascular anatomy.png|thumb|Liver vascular anatomy.]] | |||
[[File:Biliary system multilingual.png|thumb|Bile duct and pancreas anatomy. 1. Bile ducts: 2. Intrahepatic bile ducts; 3. Left and right hepatic ducts; 4. Common hepatic duct; 5. Cystic duct; 6. Common bile duct; 7. Sphincter of Oddi; 8. Major duodenal papilla; 9. Gallbladder; 10-11. Right and left lobes of liver; 12. Spleen; 13. Esophagus; 14. Stomach; 15. Pancreas: 16. Accessory pancreatic duct; 17. Pancreatic duct; 18. Small intestine; 19. Duodenum; 20. Jejunum; 21-22: Right and left kidneys.]] | |||
*Fatty liver disease due to causes other than excessive alcohol | *Fatty liver disease due to causes other than excessive alcohol | ||
*Associated with insulin resistance and [[metabolic syndrome]] | *Associated with insulin resistance and [[metabolic syndrome]] | ||
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Hepatomegaly DDX}} | |||
==Evaluation== | ==Evaluation== | ||
*[[LFTs]], CBC | *[[LFTs]], CBC | ||
*[[RUQ US]] | *[[RUQ US]] | ||
*Outpatient elastography/Fibroscan | |||
==Management== | ==Management== | ||
*Treat complications of portal hypertension, if present | *Treat complications of portal hypertension, if present | ||
*Counsel on weight loss, increased coffee consumption | |||
*Vitamin E if known F2 fibrosis | |||
==Disposition== | ==Disposition== | ||
*Discharge unless complications | |||
==See Also== | ==See Also== | ||
Latest revision as of 22:24, 9 August 2025
Background
- Formerly known as non-alcoholic steatohepatitis
Bile duct and pancreas anatomy. 1. Bile ducts: 2. Intrahepatic bile ducts; 3. Left and right hepatic ducts; 4. Common hepatic duct; 5. Cystic duct; 6. Common bile duct; 7. Sphincter of Oddi; 8. Major duodenal papilla; 9. Gallbladder; 10-11. Right and left lobes of liver; 12. Spleen; 13. Esophagus; 14. Stomach; 15. Pancreas: 16. Accessory pancreatic duct; 17. Pancreatic duct; 18. Small intestine; 19. Duodenum; 20. Jejunum; 21-22: Right and left kidneys.
- Fatty liver disease due to causes other than excessive alcohol
- Associated with insulin resistance and metabolic syndrome
Clinical Features
- Often asymptomatic or with mild RUQ discomfort
- Signs of portal hypertension (e.g. ascites) if advanced fibrosis
- Hepatomegaly
Differential Diagnosis
Hepatic Dysfunction
Infectious
- Hepatitis
- Malaria
- HIV (present in 50% of AIDS patients)[1]
- EBV
- Babesiosis, leptospirosis
- Typhoid
- Hepatic abscess, amebiasis
Neoplastic
Metabolic
Biliary
- Biliary cirrhosis
Drugs
- Alcoholic cirrhosis
- Alcoholic hepatitis
- Hepatotoxic drugs
Miscellaneous
- Other causes of cirrhosis
- Autoimmune hepatitis
- Veno-occlusive disease
- CHF (right heart failure)
Evaluation
Management
- Treat complications of portal hypertension, if present
- Counsel on weight loss, increased coffee consumption
- Vitamin E if known F2 fibrosis
Disposition
- Discharge unless complications
See Also
External Links
References
- ↑ Tintanelli's