The American Journal of Digestive Diseases

, Volume 12, Issue 1, pp 1–15 | Cite as

A fasting-blood-sample procedure in the differential diagnosis and management of hepatic disease

  • David Schwimmer
  • S. D. Klotz
  • I. J. Drekter
  • Thomas H. McGavack
Article
Received:

Summary

  1. 1.

    A single-venous-blood-specimen procedure (the “composite-test”) for the appraisal of liver function is described. Simultaneous determinations have been made of the icteric index, Van den Bergh reaction, the cephalin-cholesterol flocculation, phosphatase, total cholesterol, cholesterol esters, total proteins, albumin, and globulin. Modifications in standard procedures for the performing of these tests were made whenever necessary in the interests of economy and simplicity, whenever and wherever accuracy was not sacrificed; in some instances, errors were reduced or eliminated.

     
  2. 2.

    Results of the “composite-test” in 750 patients, performed more than 1400 times, are detailed.

     
  3. 3.

    Conditions in which the test were carried out have been grouped into intra-hepatic processes, comprising 47.3 per cent of the total; extra-hepatic obstructions, 12.7 per cent; hemolytic processes, 6.1 per cent; and miscellaneous diseases, 33.9 per cent. Diagnoses were confirmed by clinical findings and course, roentgen-ray examinations, peritoneoscopy, biopsy, operation, and autopsy.

     
  4. 4.

    The data obtained from each individual test have been separately summarized and analyzed in relation to the existing disease state.

     
  5. 5.

    As a result of serial examinations, a pattern of results to be expected in each of the following syndromes involving hepatic dysfunction has been reconstructed : hepato-cellular jaundice; obstructive jaundice due to calculus; obstructive jaundice due to neoplasm; cirrhosis and fatty degeneration of the liver; hemolytic processes; chronic passive congestion; gall-bladder disease without jaundice.

     
  6. 6.

    The “composite-test” appears to yield results which are as delicate, as accurate, and as informative as those deriving from the use of the more elaborate individual tests. Comparisons are made with the results of other tests.

     

Keywords

Cholesterol Ester Obstructive Jaundice Common Duct Rose Bengal Icteric Index 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Copyright information

© Springer-Verlag 1945

Authors and Affiliations

  • David Schwimmer
    • 2
  • S. D. Klotz
    • 3
  • I. J. Drekter
    • 1
  • Thomas H. McGavack
    • 1
  1. 1.New York
  2. 2.Metropolitan HospitalNew York
  3. 3.Medical CorpsNew York

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