Clinical signs of a Hepatobiliary disease
the rule is that a hepatobiliary dysfunction leads to a hepatobiliary clinical sign.
Polyuria PU/ Polydipsia which are multi-factorial:
renal concentrating defects.
2- Bilirubin (1st B):
A cholestatic disease causes bilirubinuria and icterus that may appear also by a hemolytic disease. Then by severe cholestasis leads to acholic grey feces.
3- Blood (2nd B):
Coagulopathy occurs due to the inability to synthesize clotting factors following severe hepatic failure or common obstruction.
Subclinical clotting disorders may convert into clinical apparent ones just after hepatic biopsy, surgery or gastroduodenal ulcer.
Severe chronic hepatic disease causes hypoalbuminemia, portal hypertension, sodium and water retention.
Also rupture of bile duct leads to bile peritonitis as well as fluid accumulation.
5- Nervous (N):
Hepatic encephalopathy occurs as a result of bacterial action on some substrate in colon that forms some potential encephalopatic toxins like ammonia, GABA and mercaptans ..etc, then by low detoxification of diseased liver or portosystemic shunt, metabolic encephalopathy rises leading to wax and wane nervous signs that may ended by coma.
6- Non-specific signs (the last N):
Vomiting and small bowel diarrhea which is less frequent than vomiting.
Hematmesis as a result of ulceration.
Anorexia and weight loss.