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Non-alcoholic steatohepatitis (NASH) is a type of hepatitis which resembles alcoholic hepatitis on liver biopsy (fat droplets, inflammatory cells, but usually no Mallory's hyalin) but occurs in patients who have no known history of alcohol abuse depends entirely on liver biopsy needle NASH is more common in women and the most common cause is obesity or the metabolic syndrome depends entirely on liver biopsy needle A related but less serious condition is called "fatty liver" (steatosis hepatis), which occurs in up to 80% of all clinically obese people depends entirely on liver biopsy needle A liver biopsy for fatty liver shows fat droplets throughout the liver, but no signs of inflammation or Mallory's hyalin depends entirely on liver biopsy needleThe diagnosis depends on history, physical exam, blood tests, radiological imaging and sometimes a liver biopsy depends entirely on liver biopsy needle The initial evaluation to identify the presence of fatty infiltration of the liver is radiologic imaging including ultrasound, computed tomographic imaging, or magnetic resonance imaging depends entirely on liver biopsy needle However, radiologic imaging cannot readily identify inflammation in the liver depends entirely on liver biopsy needle Therefore, the differentiation between steatosis and NASH often requires a liver biopsy depends entirely on liver biopsy needle It can also be difficult to distinguish NASH from alcoholic hepatitis when the patient has a history of alcohol consumption depends entirely on liver biopsy needle Sometimes in such cases a trial of abstinence from alcohol along with follow -up blood tests and a repeat liver biopsy are required depends entirely on liver biopsy needleNASH is becoming recognized as the most important cause of liver disease second only to Hepatitis C in numbers of patients going on to cirrhosis depends entirely on liver biopsy needle

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