hepatic and biliary disorders
Hepatic Fibrosis
Key Points
Self-limited, acute liver injury (eg, due to acute viral hepatitis A), even when fulminant, tends not to cause fibrosis. The most common causes of hepatic fibrosis are hepatitis B and C, metabolic dysfunction–associated steatohepatitis, and alcohol-related liver disease. Fibrosis does not cause symptoms unless it progresses to cirrhosis. Liver biopsy, although imperfect, is the gold standard diagnostic test but has been increasingly supplanted by noninvasive alternatives. Noninvasive testing, including transient elastography and magnetic resonance elastography, is becoming increasingly important. Treat the cause of fibrosis. 