Ultrasound may be helpful to investigate liver damage. Fatty liver and alcoholic hepatitis are demonstrated by changes in liver parenchymal reflectivity. A cirrhotic liver is irregular and shrunken. Doppler studies may show slow or reversed portal vein flow, which, together with splenomegaly and intra-abdominal varices, would indicate portal hypertension [1,5].
Liver biopsy can be useful to confirm diagnosis such as AH prior to treatment. With ALD and viral hepatitis, prognostic and management information can be gained from studying the necroinflammatory changes at biopsy [5].
The coagulopathy associated with liver disease increases the risk of complications and therefore the transjugular venous route is sometimes preferred [1].
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The majority of patients are diagnosed with ALD on routine blood tests.