Gastrointestinal System

{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This young man has presented with classical symptoms and signs of chronic liver disease.\n\nThe main question now is: \u0027why is this ?\u0027. The usual suspects can be rapidly excluded, given the absence of blood transfusions, promiscuity, a family history of liver disease, alcohol abuse, or use of hepatotoxic drugs.\n\nIt is important to appreciate that certain herbal supplements and \u0027native\u0027 (i.e. Chinese or Indian) medications may have a hepatotoxic effect; in many instances, patients may not mention their use unless directly asked.\n\nNote the engorgement of the superficial vessels of the anterior abdomen and chest, with blood flowing towards the superior vena cava; this is an extremely important clue which hints at inferior vena caval (IVC) obstru"}]}

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