*********** Loose fatty stools

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Nonspecific symptoms include fatigue, anorexia, nausea, and, occasionally,

vomiting, particularly in severe disorders.******* Loose, fatty stools

(steatorrhea) can occur when cholestasis prevents sufficient bile from reaching

the intestines.********************* Fever can develop in viral or alcoholic

hepatitis. >>>>>>>>>>>>>>>>>>>>>>>>>>>>

Despite necrosis, the liver can regenerate itself. Even extensive patchy

necrosis can resolve completely (eg, in acute viral hepatitis). Incomplete

regeneration and fibrosis, however, may result from injury that bridges entire

lobules or from less pronounced but ongoing damageg.

Specific diseases preferentially affect certain parts of the hepatobiliary

system (eg, acute viral hepatitis is primarily manifested by damage to

hepatocytes or hepatocellular injury; primary biliary cirrhosis, by impairment

of biliary secretion; and cryptogenic cirrhosis, by liver fibrosis and resultant

portal venous hypertension). The part of the hepatobiliary system affected

determines the symptoms, signs, and laboratory abnormalities (see also Testing

for Hepatic and Biliary Disorders). Some disorders (eg, severe alcoholic liver

disease) affect multiple liver structures, resulting in a combination of

patterns of symptoms, signs, and laboratory abnormalities.

The prognosis of serious complications is worse in older adults, who have less

capacity to recover from severe physiologic stresses and inability to tolerate

toxic accumulations.

Jj Cathcart

jjcathcart@...