Clinical Hepatology in Practice: A Systematic Approach to Pathophysiology, Diagnosis, and Treatment of Liver Disease for Gastroenterology Fellows

Clinical Hepatology in Practice: A Systematic Approach to Pathophysiology, Diagnosis, and Treatment of Liver Disease for Gastroenterology Fellows Featuring the Decision Window System It is two in the morning. The patient is bleeding, the INR is climbing, and the decision belongs to whoever is standing closest. The knowledge is somewhere in your training — but in this moment it has to assemble itself into the right action, in the right order, before a window closes that rarely reopens. This is the book written for that moment, and for the years of training that lead up to it. Most hepatology references tell you what the diseases are. Clinical Hepatology in Practice rebuilds how you reason at the bedside: recognize the pattern, branch the workup, apply the right score, and act inside the window while it is still open. Across twenty-two chapters spanning the full curriculum — from reading the liver panel to the decompensation emergencies, malignancy, transplantation, and the special host — every topic is anchored to the decision it ultimately demands. Inside this book: Decode the enzyme pattern — turn an ambiguous liver panel into a working diagnosis before the first specialist call, using the hepatocellular-versus-cholestatic branch that opens every workup. Stage before you treat — apply MELD 3.0, Child-Pugh, FIB-4, and the BCLC framework the way allocation committees and tumor boards actually use them. Master the decompensation emergencies — variceal hemorrhage, hepatorenal AKI, and the acute-on-chronic patient, reasoned step by step with the counterintuitive moves that trainees get wrong. Recognize the closing window in acute liver failure — why the coagulopathy is a prognostic signal, not a reflex to correct, and when the King's College criteria mean transplant or death. Read the liver in pregnancy — separate normal change from HELLP and acute fatty liver, and use the bile-acid threshold that times delivery and predicts fetal risk. Anticipate the immunocompromised host — hepatitis B reactivation prevented before immunosuppression, and the recognition and correct management of checkpoint-inhibitor hepatitis. Carry The Decision Window System — every chapter distilled into a four-line bedside rhythm of pattern, branch, score, and window, consolidated in The Decision Window Compendium and indexed two ways, by clinical presentation and by the score you are about to apply. Test your reasoning — board-style review questions in every chapter with full explanations, plus an integrated mastery drill that links the decision windows across the whole book. Current to contemporary practice throughout — including MASLD nomenclature, MELD 3.0, the modern portal-hypertension framework, the cure era in hepatitis C, and current malignancy and transplant approaches — and written in authoritative clinical prose rather than dense reference. Written for gastroenterology and hepatology fellows, the senior residents who carry the liver service overnight, and the hospitalists, intensivists, and advanced practice clinicians who manage liver disease on the front line. Open It Before Your Next Liver Patient — And Decide with Understanding, Not Reflex.