Dark urine occurs when bilirubin mixes with urine.
Jaundice (yellow skin and/or whites of the eyes). This is where bilirubin deposits in skin, causing an intense itch. Itching is the most common complaint by people who have liver failure. Often this itch cannot be relieved by drugs.
Swelling of the abdomen, ankles and feet occurs because the liver fails to make albumin.
Excessive fatigue occurs from a generalized loss of nutrients, minerals and vitamins.
Bruising and easy bleeding are other features of liver disease. The liver makes substances which help prevent bleeding. When liver damage occurs, these substances are no longer present and severe bleeding can occur.
The diagnosis of liver function is made by blood tests. Liver function tests can readily pinpoint the extent of liver damage. If infection is suspected, then other serological tests are done. Sometimes, one may require an ultrasound or a CT scan to produce an image of the liver. Physical examination of the liver is not accurate in determining the extent of liver damage. It can only reveal presence of tenderness or the size of liver, but in all cases, some type of radiological study is required to examine it.
Damage to the liver is sometimes determined with a biopsy, particularly when the cause of liver damage is unknown. In the 21st century they were largely replaced by high-resolution radiographic scans. The latter do not require ultrasound guidance, lab involvement, microscopic analysis, organ damage, pain, or patient sedation; and the results are available immediately on a computer screen. In a biopsy, a needle is inserted into the skin just below the rib cage and a tissue sample obtained. The tissue is sent to the labouratory, where it is analyzed under a microscope. Sometimes, a radiologist may assist the physician performing a liver biopsy by providing ultrasound guidance.
The liver is the only internal human organ capable of natural regeneration of lost tissue; as little as 25% of the liver can regenerate into a whole liver. This is, however, not true regeneration but rather compensatory growth. The lobes that are removed do not regrow and the growth of the liver is a restoration of function, not original form.
Scientific and medical works about liver regeneration often refer to the Greek TitanPrometheus who was chained to a rock in the Caucasus where, each day, his liver was devoured by an eagle, only to grow back each night. Some think the myth indicates the ancient Greeks knew about the liver’s remarkable capacity for self-repair, though this claim has been challenged.