Clinical Case Database / Category: Case Based Discussion

Alcoholic liver disease

Publication details

Philip SJ Hall MB BCh BAO (Hons), Ian Carl MPhil MRCP (Edin), Neil I McDougall MD FRCP (Edin), W. Jonathan Cash MD MRCP
Foundation Years Journal, volume 5, issue 8, p.55 (123Doc Education, London, September 2011)


This case based discussion follows the clinical course of a 42 year old man who drinks alcohol to excess and presents with deranged liver tests. It will focus on the assessment and diagnosis of liver disease caused by alcohol misuse and the management of clinical problems related to this disease process.

Access the Clinical Cases Database

A subscription is required to read the full article. Please subscribe using one of the options below.

Foundation Years Clinical Cases Database£29.006 months
Add to cart
Foundation Years Clinical Cases Database£39.0012 months
Add to cart


Philip SJ Hall MB BCh BAO (Hons)

SHO Gastroenterology
The Liver Unit, Royal Victoria Hospital, Belfast

Ian Carl MPhil MRCP (Edin)

Gastroenterology SPR
The Liver Unit, Royal Victoria Hospital, Belfast

Neil I McDougall MD FRCP (Edin)

Consultant Gastroenterologist and Hepatologist
The Liver Unit, Royal Victoria Hospital, Belfast

W. Jonathan Cash MD MRCP

Consultant Gastroenterologist and Hepatologist
The Liver Unit, Royal Victoria Hospital, Belfast


1. Alcohol use disorders: physical complications. NICE guidelines 2010.
2. Stranges S, Freudenheim JL, Muti P, Farinaro E, Russell M, Nochajski TH et al. Differential effects of alcohol drinking pattern on liver enzymes in men and women. Alcohol Clin.Exp.Res. 2004;28:949-56.
3. Moussavian SN, Becker RC, Piepmeyer JL, Mezey E, Bozian RC. Serum gamma-glutamyl transpeptidase and chronic alcoholism. Influence of alcohol ingestion and liver disease. Dig.Dis.Sci. 1985;30:211-4.
4. McCullough AJ. Update on nonalcoholic fatty liver disease. J.Clin. Gastroenterol. 2002;34:255-62.
5. Marsano LS, Mendez C, Hill D, Barve S, McClain CJ. Diagnosis and treatment of alcoholic liver disease and its complications. Alcohol Res. Health 2003;27:247-56.
6. Maddrey WC, Boitnott JK, Bedine MS, Weber FL, Jr., Mezey E, White RI, Jr. Corticosteroid therapy of alcoholic hepatitis. Gastroenterology 1978;75:193-9.
7. Forrest EH, Morris AJ, Stewart S, Phillips M, Oo YH, Fisher NC et al. The Glasgow alcoholic hepatitis score identifies patients who may benefit from corticosteroids. Gut 2007;56:1743-6.
8. Grant A NJDCSS. Guidelines on the use of Liver Biospy in Clinical Practice. British Society of Gastroenterology. 2004.
9. O'Shea RS, Dasarathy S, McCullough AJ. Alcoholic liver disease. Hepatology 2010;51:307-28.
10. Martinez SM, Crespo G, Navasa M, Forns X. Noninvasive assessment of liver fibrosis. Hepatology 2011;53:325-35.
11. Foucher J, Chanteloup E, Vergniol J, Castera L, Le Bail B, Adhoute X et al. Diagnosis of cirrhosis by transient elastography (FibroScan): a prospective study. Gut 2006;55:403-8.
12. Mueller S, Millonig G, Sarovska L, Friedrich S, Reimann FM, Pritsch M et al. Increased liver stiffness in alcoholic liver disease: differentiating fibrosis from steatohepatitis. World J.Gastroenterol. 2010;16:966-72.
13. Runyon BA. Management of adult patients with ascites due to cirrhosis. Hepatology 2004;39:841-56.
14. EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis. J.Hepatol. 2010;53:397-417.
15. Ponziani FR, Zocco MA, Campanale C, Rinninella E, Tortora A, Di Maurizio L et al. Portal vein thrombosis: insight into physiopathology, diagnosis, and treatment. World J.Gastroenterol. 2010;16:143-55.
16. Garcia-Tsao G, Sanyal AJ, Grace ND, Carey WD. Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis. Am.J.Gastroenterol. 2007;102:2086-102.
17. Soares-Weiser K, Brezis M, Tur-Kaspa R, Paul M, Yahav J, Leibovici L. Antibiotic prophylaxis of bacterial infections in cirrhotic inpatients: a meta-analysis of randomized controlled trials. Scand.J.Gastroenterol. 2003;38:193-200.
18. Scottish Intercollegiate Guidelines Network. Management of acute upper and lower gastrointestinal bleeding. A national clinical guideline. SIGN guidelines 2009.
19. Thomson AD, Bird GL, Saunders JB. Alcoholic liver disease. Gut 1991;Suppl:S97-103.


Conflict Of Interest

The Journal requires that authors disclose any potential conflict of interest that they may have. This is clearly stated in the Journal’s published “Guidelines for Authors”. The Journal follows the Guidelines against Conflict of Interest published in the Uniform Requirements for Manuscripts Submitted to Biomedical Journals (

Financial Statement

The authors of this article have not been paid. The Journal is financed by subscriptions and advertising. The Journal does not receive money from any other sources. The decision to accept or refuse this article for publication was free from financial considerations and was solely the responsibility of the Editorial Panel and Editor-in-Chief.

Patient Consent statement

All pictures and investigations shown in this article are shown with the patients’ consent. We require Authors to maintain patients’ anonymity and to obtain consent to report investigations and pictures involving human subjects when anonymity may be compromised. The Journal follows the Guidelines of the Uniform Requirements for Manuscripts ( The Journal requires in its Guidelines for Authors a statement from Authors that “the subject gave informed consent”.

Animal & Human Rights

When reporting experiments on human subjects, the Journal requires authors to indicate whether the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the HelsinkiDeclaration of 1975, as revised in 2008.

About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.