In collaboration with Consulting Editor, Dr. Norman Gitlin, Dr. Steven Flamm has put together another great update for the hepatology consult. Articles are submitted by expert author and in the format of the clinical review article, provide timely data for diagnosis and treatment. Specific areas addressed include the following: Management of esophageal and gastric varices; Severe thrombocytopenia in chronic liver disease and new management approaches; Pathology in chronic liver disease; Alpha 1 antitrypsin disease and chronic liver disease in adults; Evaluation of management of Budd-Chiari; HBV reactivation with immunosuppressive therapy; Homeopathic products and hepatotoxicity; New uses of TIPS; Dermatologic manifestations of chronic liver disease; Acute on chronic liver failure; Cholangiocarcinoma; Diagnosis and management of hepatic adenoma and focal nodular hyperplasia; Emerging data about the microbiome in chronic liver disease; and Acute viral hepatitis aside from HAV, HBV, and HCV. Readers will come away with the information they need to improve patient outcomes.