The liver is accountable for many critical functions within the body and loss of those functions can cause signifi cant damage to the body. Liver disease is a extensive term that covers all aspects that cause the liver to fail to perform its proper functions. Acute liver failure indicates the development of severe acute liver injury with impaired synthetic function without preexisting of clinical liver disease. However, chronic liver disease is characterized by destruction of the hepatic tissue. Early changes, such as fatty liver can progress via infl ammation and fi brosis to cirrhosis. The main causes for liver dysfunction includedyslipidemia, obesity, viral and parasitic infection, drugs and environmental pollution, alcohol abuse, autoimmunity, and genetic defective such as hemochromatosis. The present review almost covers all the previous aspects that lead to liver dysfunction.

Background: Ascaris lumbricoides is one of the most frequent human helminthiasis, but the complication with liver abscess is very rare and severe, being a challenge for the correct and timely diagnosis.

A 51 year - old – male, consuming alcohol almost 180 ml/ day for 20 years was admitted elsewhere with vomiting for 10 days, reduced urine output for 5 days and severe epigastric pain radiating to back for 3 days. In the next 3 days he developed fever alongside with pain, swelling and redness of the lower extremities, jaundice and breathlessness on exertion.

Objective: Vitamin D (Vit D) defi ciency is a very common problem in obese children, but clinical guidelines for maintenance or treatment have not been published for this population. The aim was to assess the benefi t of 2 months Vit D supplementation given to defi cient obese children from WV.

Background: Acute cholangitis is a life threatening condition with multiple possible origins; one of this is the distal intermittent obstruction of biliary three by a duodenum yuxtapapillar diverticulum, an infrequent condition known as Lemmel syndrome. Case: An 83-year-old man come to emergency room complaining for intense abdominal pain and fever. Pathological background included cholecystectomy 4 years ago and right inguinal hernia repair 2 years before. He presents with epigastric, moderate intensity pain 4 days before, developing general discomfort, anorexia, asthenia, adinamia and nausea. Last 24 hours presents fever of 39.5º and jaundice. At physical exam with Glasgow 12, jaundice, dehydrated, tachycardia of 95 beats per minute, tachypnea 25 breaths per minute, abdominal pain located in epigastrium and right hypochondria, Murphy +, extremities with delayed capillary fulfi ll. Laboratories report hemoglobin 14.7 mg/dL, leucocytes 22000, neutrophils 95%, platelets 18500, total bilirubin 17 mg/dL, direct bilirubin 13.2 mg/dL. Ultrasound reports gallbladder absence, with intrahepatic biliary ducts dilated 7mm, and common bile duct 9 mm without intraluminal content. Medical treatment including metronidazole plus imipenem were initiated with good results and cholangitis resolution. ERCP was performed and this study reports a yuxtapapillar diverticulum type 1, a sphincterotomy was completed with clear biliary liquid evacuated and with posterior 10 French x 10 cm endoprothesis placement. Two days after that the patient was discharged but after one week he returned by mild cholangitis. Colangio-pancreatic magnetic resonance report similar fi ndings that in ERCP, with yuxtapapillar duodenal diverticulum. By clinical presentation and evolution Lemmel syndrome was diagnosed and conservative management with ERCP and sphincterotomy completed by the good outcomes, with patient discharge uneventfully 4 days later.