Abstract

Patients presenting with chronic liver injury should be classified as having hepatocellular, cholestatic or mixed injury, because classification can narrow the causes of injury, making history taking and physical examination more effective. Diagnosis of drug- and alcohol-induced liver injury depends on careful history taking. Most patients with chronic liver diseases are asymptomatic, and key examinations for the diagnosis of each disease should be performed in an effective order. Severity of liver injury is estimated by PT-INR and T-Bil. Patients at risk for transition to hepatic failure should likely be transferred to a transplantation center.