Sherlock's Diseases of the Liver and Biliary System
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Sherlock's Diseases of the Liver and Biliary System

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Awarded first prize in the Internal Medicine category of the British Medical Association Book of the Year Awards, 2012
Following a Tradition of Excellence
from reviews of previous editions:
"the best source of synthesized clinical wisdom" Gastroenterology
"a tour de force in terms of knowledge and effort" The New England Journal of Medicine
"the foremost liver book in the world" The Journal of the American Medical Association
"beautifully produced" Hepatology
Over the past 56 years, thousands of physicians have depended on Diseases of the Liver and Biliary System. Its didactic and reliable clinical guidance was - and still is - beyond comparison.
This brand-new edition, now named Sherlock's Diseases of the Liver and Biliary System, after the late Professor Dame Sheila Sherlock, continues to provide concise clinical guidance for all those treating patients with hepato-biliary disease.
Enabling clinicians to formulate incisive diagnoses and appropriate treatment strategies, this book has been updated to reflect the advances that have been made in the last 10 years, providing didactic and reliable clinical guidance in hepatology from the world s leading experts.
A consistent chapter structure allows readers to access the information immediately, with summary boxes and key learning points throughout, and special emphasis on the latest in evidence-based clinical guidance. And for the first time, this edition now offers a free companion website providing the 680 full-color illustrations and figures in the book, for use in scientific presentations.
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Product details

  • Hardback | 792 pages
  • 218 x 280 x 40mm | 2,521.96g
  • John Wiley and Sons Ltd
  • Wiley-Blackwell (an imprint of John Wiley & Sons Ltd)
  • Chicester, United Kingdom
  • English
  • 12th Edition
  • 190 SW-Abb., 190 Farbabb., 300 Tabellen
  • 1405134895
  • 9781405134897
  • 616,361

Review quote

"This is a concise, updated, and well-written book that justifies replacing the previous edition. It is definitively useful and exhibits the same high quality of other currently available books in hepatology. I know I will consult my copy on a frequent basis -- an unusual event in this era of online material." (Doody's, 16 March 2012) "James Dooley is to be congratulated on his courage and dedication along with his clearly inspiring leadership to contributing authors has not allowed Sheila's volume to die with her passing. The Hepatology world, has been given a thoroughly up-to-date, exciting and cleverly produced volume which competitors will have greatest difficulty in matching." (Institute of Hepatology, 2011)
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About James S. Dooley

James Dooley, Editor-in-Chief, worked with Professor Dame Sheila Sherlock on this book for three editions before her death in December 2001. He is a Consultant Hepatologist at the Royal Free Hospital, London.
Andrew Burroughs is a Consultant Physician and Hepatologist at the Royal Free Hospital, Liver Transplantation and Hepato-biliary Medicine Unit. He qualified in Liverpool with a MB ChB Honours in 1976, gained his MRCP in 1978 and FRCP in 1991. He is a Fellow of the European Board of Gastroenterology. He has been Scientific Secretary of the European Association for the Study of the Liver 1997-1999. He continues his association with EASL as administrative secretary until 2001. He is a council member of the United European Gastroenterology Federation until 2002, and a council member of the International Association for the Study of the Liver. He is a member of the MRC advisory board in the UK, from 1997 onwards. He was a member of Council of the British Society of Gastroenterology from 1992 to 1995. Andrew Burroughs main research interests are portal hypertension, variceal bleeding and coagulopathy, primary biliary cirrhosis, prognosis in liver disease and liver transplantation. He has published over 200 peer-reviewed articles.
Anna Lok is a Professor of Internal Medicine and the Director of Clinical Hepatology at the University of Michigan Medical Center. Her research focuses on the epidemiology and treatment of hepatitis B and C viruses. Millions of people worldwide are infected and are at risk for hepatitis-associated cirrhosis and hepatocellular carcinoma. Dr. Lok has made seminal contributions to our understanding of the natural history of hepatitis B and the role of hepatitis B virus genotypes and variants in the outcome of chronic hepatitis B infection. She has also made contributions to the treatment of hepatitis-induced diseases. She is currently testing new antiviral therapies for hepatitis B, developing cost-effective methods for preventing recurrent hepatitis B infection following liver transplantation, and studying the long-term effects of interferon treatment in patients with hepatitis C. During her distinguished career, she has received numerous awards for research and teaching.
Jenny Heathcote, Toronto Western Hospital, Canada.
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Back cover copy

The review from Gastroenterology sums up the appeal of this book: "More than any other text in liver diseases, this one provides the best source of synthesised clinical wisdom, a currency in ever increasingly short supply as our fund of factual knowledge burgeons. Indeed, if one demanded that an author confine the breadth of our knowledge in liver disease into a readable clinical textbook of less than 700 pages, he or she could do no better than to direct that individual to Sherlock and Dooley's Diseases of the Liver and Biliary System."
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Table of contents

List of Contributors, xi
Preface to the Twelfth Edition, xv
Preface to the First Edition, xvi
1 Anatomy and Function, 1 Jay H. Lefkowitch
Development of the liver and bile ducts, 1
Anatomy of the liver, 1
Functional liver anatomy: sectors and segments, 3
Anatomical abnormalities of the liver, 4
Anatomy of the biliary tract, 5
Surface marking, 6
Methods of examination, 6
Microanatomy of the liver, 7
Hepatic ultrastructure (electron microscopy) and organelle functions, 11
Functional heterogeneity of the liver, 15
Dynamics of the hepatic microenvironment in physiology and disease, 16
Hepatocyte death and regeneration, 17
2 Assessment of Liver Function, 20 Sandeep Mukherjee & John L. Gollan
Selection of biochemical tests, 20
Bile pigments, 21
Serum enzyme tests, 22
Quantitative assessment of hepatic function, 25
Lipid and lipoprotein metabolism, 25
Bile acids, 27
Amino acid metabolism, 30
Plasma proteins, 30
Carbohydrate metabolism, 33
Effects of ageing on the liver, 33
3 Biopsy of the Liver, 36 David Patch & Amar Paul Dhillon
Selection and preparation of the patient, 36
Techniques, 37
Risks and complications, 40
Sampling variability, 41
Naked-eye appearances, 43
Preparation of the specimen, 43
Interpretation, 43
Indications, 43
Special methods, 45
4 Haematological Disorders of the Liver, 48 Pramod K. Mistry & Dhanpat Jain
The liver and blood coagulation, 50
Haemolytic jaundice, 53
The liver in haemolytic anaemias, 54
The liver in myelo- and lymphoproliferative disease, 57
Leukaemia, 57
Bone marrow transplantation, 57
Lymphoma, 58
Lipid storage diseases, 62
5 Acute Liver Failure, 70 Shannan R. Tujios & William M. Lee
Definition, 70
Epidemiology and aetiologies, 71
Clinical features, 74
Initial investigations, 75
Complications and management of acute liver failure, 77
Specific therapies, 84
Prognosis, 86
Liver transplantation, 86
Liver support systems, 88
Conclusion, 88
6 Hepatic Fibrogenesis, 94 Meena B. Bansal & Scott L. Friedman
Introduction, 94
Natural history of hepatic fibrosis, 94
Cellular and molecular features of hepatic fibrosis, 95
Clinical aspects of hepatic fibrosis, 100
Emerging antifi brotic targets and strategies, 101
7 Hepatic Cirrhosis, 103 P. Aiden McCormick
Definition, 103
Causes of cirrhosis, 103
Anatomical diagnosis, 104
Reversible cirrhosis, 106
Clinical cirrhosis: compensated versus decompensated, 106
Vasodilatation and hyperdynamic circulation, 108
Prognosis (Child Pugh score, MELD, UKELD), 110
Clinical and pathological associations, 111
Management, 117
8 Hepatic Encephalopathy in Patients with Cirrhosis, 121 Marsha Y. Morgan
Classification, 121
Diagnosis, 124
Differential diagnosis, 130
Hepatic encephalopathy and liver transplantation, 131
Prognosis, 131
Pathogenesis, 131
Management of hepatic encephalopathy, 139
Prevention, 146
9 The Hepatic Artery, Portal Venous System and Portal Hypertension: the Hepatic Veins and Liver in Circulatory Failure, 152 Andrew K. Burroughs
The hepatic artery, 152
The portal venous system, 156
Haemodynamics of portal hypertension, 160
Clinical features of portal hypertension, 162
Diagnosis of varices, 163
Imaging the portal venous system, 166
Classification of portal hypertension, 171
Extrahepatic portal venous obstruction, 171
Presinusoidal intrahepatic and sinusoidal portal hypertension, 176
Bleeding oesophageal varices, 179
Management of acute variceal bleeding, 181
The hepatic veins, 189
Budd Chiari (hepatic venous obstruction) syndrome, 191
Circulatory failure, 197
10 Ascites, 210 Guadalupe Garcia-Tsao
Mechanisms of ascites formation, 210
Clinical features, 213
Differential diagnosis, 215
Spontaneous bacterial peritonitis, 216
Treatment of cirrhotic ascites, 218
Hyponatraemia, 222
Refractory ascites, 223
Hepatorenal syndrome, 224
Prognosis, 228
11 Jaundice and Cholestasis, 234 Elwyn Elias
Introduction, 234
Classification of jaundice, 234
Physiology and pathophysiology, 235
Syndrome of cholestasis, 240
Investigation of the jaundiced patient, 245
Differential diagnosis, 247
Treatment, 249
Familial non-haemolytic hyperbilirubinaemias, 250
12 Gallstones and Benign Biliary Diseases, 257 James S. Dooley
Imaging, 258
Composition of gallstones, 261
Formation of cholesterol stones, 261
Factors in cholesterol stone formation, 264
Pigment gallstones, 266
Natural history of gallbladder stones, 266
Acute calculous cholecystitis, 267
Empyema of the gallbladder, 269
Emphysematous cholecystitis, 269
Chronic calculous cholecystitis, 269
Acalculous cholecystitis, 270
Cholecystectomy, 271
Postcholecystectomy bile duct damage, 273
Postcholecystectomy syndromes, 275
Non-surgical treatment of gallstones in the gallbladder, 276
Other gallbladder pathology, 277
Biliary fi stulae, 279
Gallstone ileus, 280
Bile peritonitis, 280
Association between cholecystectomy and colorectal cancer, 281
Common duct stones, 281
Management of duct stones, 282
Haemobilia, 285
Bile duct bowel anastomotic stricture, 285
Chronic pancreatitis, 286
Primary sclerosing cholangitis and autoimmune pancreatitis, 287
Bile duct pathology following liver transplantation, 287
13 Malignant Biliary Diseases, 294 Rahul S. Koti & Brian R. Davidson
Carcinoma of the gallbladder, 294
Carcinoma of the bile duct (cholangiocarcinoma), 296
Intrahepatic cholangiocarcinoma, 302
Other biliary malignancies, 302
Metastases at the hilum, 302
Periampullary carcinoma, 302
Conclusions, 308
14 Cysts and Congenital Biliary Abnormalities, 312 Giorgina Mieli-Vergani & Nedim Hadzic
Fibropolycystic diseases, 312
Adult polycystic disease, 314
Congenital hepatic fibrosis, 316
Caroli's disease, 318
Microhamartoma (von Meyenberg complexes), 319
Choledochal cysts, 320
Congenital anomalies of the biliary tract, 322
15 Primary Biliary Cirrhosis, 329 Margaret F. Bassendine
Clinical features, 329
Diagnosis, 332
Aetiology, 335
Epidemiology and genetics, 336
Treatment, 337
Prognosis, 338
16 Sclerosing Cholangitis, 342 Simon Rushbrook & Roger W. Chapman
Introduction, 342
Primary sclerosing cholangitis, 342
Secondary sclerosing cholangitis, 348
References, 350
17 Enterically Transmitted Viral Hepatitis: Hepatitis A and Hepatitis E, 353 Peter Karayiannis & Howard C. Thomas
General features of enterically transmitted viral
hepatitis, 353
Hepatitis A virus, 358
Hepatitis E virus, 362
18 Hepatitis B, 367 Anna S. F. Lok
Introduction, 367
Hepatitis B virus, 367
Immune response and mechanisms of hepatic injury, 369
Epidemiology, 370
Prevention, 371
Diagnosis, 374
Clinical manifestations, 376
Natural history, 377
Treatment, 380
19 Hepatitis D, 393 Patrizia Farci
History, 393
Hepatitis D virus, 393
Epidemiology, 395
Pathogenesis, 396
Modes of infection and clinical course, 396
Diagnosis, 399
Treatment, 400
Prevention, 403
20 Hepatitis C, 406 Geoffrey Dusheiko
Introduction, 406
Epidemiology, 406
Virology, 408
Pathology and pathogenesis, 409
Diagnostic tests for hepatitis C, 410
Acute hepatitis C, 411
Chronic hepatitis C, 412
21 Hepatitis due to Non-A E Viruses, 427 Antonio Craxi & Rosa Di Stefano
General features of non-A E hepatitides, 427
Hepatotropic viruses, 429
Systemic viral infections that often cause transient liver involvement, 431
22 HIV and the Liver, 438 Marion G. Peters & Vincent Soriano
Viral hepatitis and human immunodefi ciency virus (HIV) infection, 438
Cirrhosis and liver transplantation, 444
HIV-associated opportunistic infections and the liver, 444
HIV-associated neoplasms of the liver, 446
Antiretroviral-related liver injury in HIV, 446
23 Autoimmune Hepatitis and Overlap Syndromes, 452 Gideon M. Hirschfield & E. Jenny Heathcote
Introduction, 452
Disease overview, 452
Biological determinants of disease, 454
Disease presentation, 455
Laboratory features, 457
Imaging, 459
Liver biopsy and histological features, 459
Differential diagnosis, 461
Diagnostic dilemmas, 463
Making a diagnosis in practice, 463
Management strategies, 464
Pregnancy and autoimmune hepatitis, 468
Contraception choices for patients with autoimmune hepatitis, 469
The elderly and autoimmune hepatitis, 469
Childhood-onset autoimmune hepatitis, 469
Autoimmune hepatitis and liver transplantation, 471
Overlap syndromes, 471
Conclusion, 475
24 Drug-Induced Liver Injury, 478 Leonard B. Seeff & Robert J. Fontana
Introduction, 478
Worldwide epidemiology, 479
Expressions of hepatotoxicity, 481
Classification of hepatotoxicity, 482
Predictors of susceptibility and outcome in druginduced liver injury, 483
Mechanisms of injury, drug metabolism and pharmacokinetics, 484
Diagnostic approaches and causality assessment of drug-induced liver injury, 487
Clinical and biochemical presentations of drug-induced liver disease, 488
Assessment of suspected drug-induced liver disease, 489
Assessing causality for drug-induced liver disease, 489
Medical management, 491
Liver injury from specifi c drugs, 491
25 Alcohol and the Liver, 507 Stephen Stewart & Chris Day
Introduction, 507
Alcohol metabolism, 507
Pathogenesis, 508
Susceptibility, 510
Histological features, 511
Clinical features, 513
Clinical syndromes, 516
Prognosis, 517
Treatment, 517
26 Iron Overload States, 521 Paul Adams
Normal iron metabolism, 521
Iron overload and liver damage, 523
Genetic haemochromatosis, 523
Other iron storage diseases, 530
27 Wilson's Disease, 534 Eve A. Roberts
Molecular genetics: pathogenesis, 534
Pathology, 536
Clinical picture, 537
Genetic strategies, 539
Diagnostic diffi culties, 540
Treatment, 540
Prognosis, 542
Indian childhood cirrhosis, 543
28 Non-alcoholic Fatty Liver Disease and Nutrition, 546 Stephen H. Caldwell & Curtis K. Argo
Introduction, 546
Clinical features, 548
Laboratory testing, 549
Mitochondriopathies and lipodystrophy, 549
Epidemiology of non-alcoholic fatty liver disease, 549
Pathogenesis of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis, 550
The natural history of non-alcoholic fatty liver disease (non-alcoholic steatohepatitis and non-NASH fatty liver), 556
Therapy of non-alcoholic fatty liver disease, 558
Other forms of non-alcoholic fatty liver, 560
29 The Liver in the Neonate, in Infancy and Childhood, 568 Deirdre A. Kelly
Investigation of liver disease in children, 568
Neonatal jaundice, 569
Neonatal liver disease (conjugated hyperbilirubinaemia), 571
Neonatal hepatitis syndrome, 574
Inherited disease in the neonate, 576
Genetic cholestatic syndromes, 578
Structural abnormalities: biliary atresia and choledochal cyst, 580
Acute liver failure in infancy, 583
Liver disease in older children, 585
Metabolic disease in older children, 587
Cirrhosis and portal hypertension, 594
Liver transplantation, 594
Tumours of the liver, 595
30 The Liver in Pregnancy, 602 Andrew K. Burroughs & E. Jenny Heathcote
Normal pregnancy, 602
Liver disease in pregnancy, 602
Diseases specifi c to pregnancy, 602
Diseases of late pregnancy, 603
Pregnancy in those with acute or chronic liver disease, 608
Hepatotoxic drugs and the pregnant woman, 609
Pre-existing liver disease, 610
Pregnancy in liver transplant recipients, 611
31 The Liver in Systemic Disease, 615 Humphrey J. F. Hodgson
Collagen-vascular and autoimmune disorders, 615
Hepatic granulomas, 616
The liver in diabetes mellitus, 622
Liver and thyroid, 622
Liver and adrenal, 623
Liver and growth hormone, 623
Amyloidosis, 623
Porphyrias, 626
Non-metastatic complications of malignancy, 628
Bone-marrow/stem cell transplantation; graft-versushost disease, 629
32 The Liver in Infections, 632 Christopher C. Kibbler
Introduction, 632
Jaundice of infections, 632
Pyogenic liver abscess, 632
Hepatic amoebiasis, 635
Tuberculosis of the liver, 637
Hepatic actinomycosis, 638
Syphilis of the liver, 639
Perihepatitis, 640
Leptospirosis, 640
Relapsing fever, 643
Lyme disease, 643
Rickettsial infections, 643
Fungal infections, 644
Schistosomiasis (bilharzia), 645
Malaria, 647
Kala-azar (visceral leishmaniasis), 648
Hydatid disease, 648
Ascariasis, 652
Strongyloides stercoralis, 654
Trichinosis, 654
Toxocara canis (visceral larva migrans), 654
Liver fl ukes, 654
33 Space-Occupying Lesions: the Diagnostic Approach, 660 Neil H. Davies & Dominic Yu
Ultrasound, 660
Computed tomography, 661
Magnetic resonance imaging, 663
Radioisotope scanning, 666
Positron emission tomography, 667
MR spectroscopy, 668
Conclusions and choice of imaging technique, 669
34 Benign Liver Tumours, 671 Ian R. Wanless
Diagnosis of focal liver lesions, 671
Hepatocellular tumours, 671
Biliary and cystic lesions, 676
Mesenchymal tumours, 677
35 Primary Malignant Neoplasms of the Liver, 681 Morris Sherman
Hepatocellular carcinoma, 681
Cholangiocarcinoma, 696
Other malignant neoplasms of the liver, 698
36 Hepatic Transplantation, 704 Andrew K. Burroughs & James O'Beirne
Selection of patients, 704
Candidates: outcome, 706
Absolute and relative contraindications, 712
General preparation of the patient, 713
Donor selection and operation, 713
The recipient operation, 714
Immunosuppression, 716
Postoperative course, 717
Post-transplantation complications, 718
Conclusion, 726
37 Liver Transplantation in Patients with Hepatitis B, C or HIV Infection, 731 Norah Terrault
Introduction, 731
Hepatitis B and liver transplantation, 731
Hepatitis C and liver transplantation, 735
HIV and liver transplantation, 740
References, 741
Index, 747
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Review Text

"This is a concise, updated, and well-written book that justifies replacing the previous edition. It is definitively useful and exhibits the same high quality of other currently available books in hepatology. I know I will consult my copy on a frequent basis -- an unusual event in this era of online material." (Doody s, 16 March 2012)

"James Dooley is to be congratulated on his courage and dedication along with his clearly inspiring leadership to contributing authors has not allowed Sheila s volume to die with her passing. The Hepatology world, has been given a thoroughly up-to-date, exciting and cleverly produced volume which competitors will have greatest difficulty in matching." (Institute of Hepatology, 2011)
show more