MISCELLANEOUS LIVER DISORDERS

Liver disorders in pregnancy range from mild asymptomatic biochemical changes to fulminant hepatic failure. Advances in the management of a number of serious conditions have lead to improvement in maternal and fetal survival. Hepatobiliary complications of total parenteral nutrit ion appear to occur more commonly in patients with preexisting liver d isease. Peliosis hepatis is associated with a variety of conditions in cluding tuberculosis, malignancy, anabolic steroids, Rochalimea hensel ae infection with HIV infection, and azathioprine therapy post-renal t ransplantation. The value of magnetic resonance imaging in the identif ication of specific benign hepatic tumors has added to the diagnostic armamentarium in these disorders. Also, computed tomography arterial p ortography can be used to detect hepatocellular carcinomas and to diff erentiate between adenomas and hepatic cancers. The documented associa tion between hepatic adenomas and their transformation to hepatic canc ers is extremely rare. Nevertheless, the discontinuation of oral contr aceptives, if applicable, should be advocated. The treatment of hepati c metastases due to carcinoid or islet cell carcinomas entails a varie ty of regimens ranging from pharmacotherapy, chemotherapy, and surgery .