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Medical Author:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• Liver facts
• Liver overview
• How large is the liver?
• Where is the liver located (liver anatomy)?
• What is the function of the liver?
• What special features enable the liver to do so much?
• What diseases affect the liver?
• How do liver diseases cause symptoms?
• What about blood tests for the diagnosis of liver disease?
• Why does the doctor examine the liver?
• What is a liver biopsy?
• What else is important about the liver?
• Find a local Doctor in your town
• Liver Index

The doctor examines the liver as part of the abdominal physical examination to try to gain helpful diagnostic information about a patient's liver condition. For example, the liver can be tender (painful to touch) with acute hepatitis or feel hard and irregular (bumpy) with cancer of the liver. Also, some conditions can cause the liver to enlarge (fatty liver or certain types of chronic hepatitis or cirrhosis), while others can make the liver smaller (advanced cirrhosis).

The most accurate way to diagnose the type of liver disease is by doing a liver biopsy, although a biopsy is not necessary in most cases. This procedure involves removing, with a thin hollow needle, a small piece of liver tissue for microscopic study. What's interesting about a liver biopsy is that the tiny sample is usually representative of the disease (pathology) in the rest of this large organ. Put another way, most liver disease involves the entire liver. When the disease is localized to only a small part of the liver, as for example, cancer usually is, the biopsy can be done with ultrasonic visual guidance to be certain that the small, involved area is biopsied.

There's one other interesting point about this remarkable organ. The liver has an extraordinary capacity to regenerate (reproduce itself). For example, damage the liver, and it will soon regenerate in an attempt to restore its functions. Cut out a part of the liver, and it likewise will grow back (regenerate) rapidly. In fact, when a person donates a part of her or his liver for transplantation, much of the part that is removed will soon grow back.

There's a famous story in Greek and Roman mythology that testifies to the liver's great capacity to regenerate. Witness Prometheus chained to a rock on a mountain. This confinement was his punishment because he had displeased the ruler Zeus (Jupiter, if you prefer Latin to Greek) by providing fire (and other benefits) to humankind. Picture a vulture pecking away at the liver of the helpless Prometheus. He survived, however, according to the legend, because his liver renewed itself as fast as the vulture devoured it.

REFERENCE: Fauci, Anthony S., et al. Harrison's Principles of Internal Medicine. 17th ed. United States: McGraw-Hill Professional, 2008.

Previous contributing author: Leslie J. Schoenfield, MD, PhD