Laparoscopic findings in patients with nonalcoholic steatohepatitis.
OBJECTIVE
Laparoscopic observation of the liver is important to diagnose liver conditions accurately. However, the laparoscopic findings of nonalcoholic steatohepatitis (NASH) have not been characterized. The aim of this study was to clarify the laparoscopic characteristics of NASH.


METHODS
Twenty-four patients were enrolled. The degrees of hepatomegaly, color and irregularity of the liver surface, and the presence of depressions, patches, and vesicles were investigated. These laparoscopic findings were compared among NASH, alcoholic liver disease (ALD), and autoimmune hepatitis (AIH).


RESULTS
Mild hepatomegaly, dullness of the liver edge, increased fat accumulation of the round ligament, and whitish markings were found in most of the patients with NASH. Small depressions were observed in approximately 70% of the patients. As fibrosis developed, the liver surface became whiter and more uneven. Compared with patients with ALD and AIH, increased fat accumulation of the round ligament and dullness of the liver edge were observed more frequently in those with NASH. However, coarse and groove-like depressions were rare in NASH patients.


CONCLUSIONS
Several findings, including mild hepatomegaly, increased fat accumulation of the round ligament, rounded liver edge, whitish markings, and small depressions were common in patients with NASH. However, coarse and groove-like depressions were rare. These findings may be helpful for confirming a diagnosis of NASH.
Tanaka
Naoki
N
Division of Gastroenterology, Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan. naopi@hsp.md.shinshu-u.ac.jp
Ichijo
Tetsuya
T
Okiyama
Wataru
W
Mutou
Hidetomo
H
Misawa
Noriko
N
Matsumoto
Akihiro
A
Yoshizawa
Kaname
K
Tanaka
Eiji
E
Kiyosawa
Kendo
K
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D015331:Cohort Studies; D003937:Diagnosis, Differential; D005234:Fatty Liver / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D019693:Hepatitis, Autoimmune / Q000175:diagnosis* / Q000473:pathology; D006529:Hepatomegaly / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D010535:Laparoscopy / Q000379:methods*; D008108:Liver Diseases, Alcoholic / Q000175:diagnosis* / Q000473:pathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011336:Probability; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index