The liver is a vital, multifunctional organ located in the right upper quadrant beneath the diaphragm. Blood is supplied to the liver by the hepatic artery and the portal vein. The portal vein drains the capillaries of the alimentary canal and pancreas. Arterial and portal blood flows into the hepatic sinusoids, which have direct contact with hepatic cells. The functions of the liver are multiple and include metabolism of fats, proteins, and glucose; synthesis and secretion of bile salts; storage of vitamins and minerals; metabolism and detoxification of endogenous and exogenous substances; and urea synthesis. Manifestations of liver disease are attributable to hepatocellular failure and portal hypertension. Jaundice, decreased clotting factors, hypoalbuminemia, decreased vitamins d and. K, and feminization are attributed to hepatocellular failure. Portal hypertension may result in gi congestion with the development of esophageal or gastric varices, hemorrhoids, splenomegaly, and ascites.