History

Often there is very little history available, however it should focus mainly on:

  • risk factors for viral hepatitis such as IV drug use, recent tattoos, travel and sexual histories
  • family history of Wilson’s or haemochromatosis
  • Exposure to viruses, drugs or toxins but can often be non-specific with symptoms of anorexia or vomiting
  • Recent GI upset can point to mushroom poisoning
  • Recent shock/arrest can point towards acute ischaemic injury
  • Breast cancer, melanoma, lymphoma and small cell cancers can give rise to malignant infiltration
  • Active malignancy can also be responsible for Budd-Chiari syndrome
  • Patients with severe encephalopathy, the history may be limited or unavailable