LIVER 3 Flashcards
3 hepatic liver diseases
fatty liver
cirrhosis
hepatic fibrosis
Fatty Infiltration caused by and results from
Caused by chronic hepatic injury and results from an accumulation of abnormal triglycerides and lipids
why has fatty infiltration become a concern
increasing childhood obesity rates
is fatty infiltration permanent
can be reversible
Diffuse Fatty Infiltration sono appearance
Large and echogenic liver with decreased vis of the hepatic veins
focal fatty infiltration appearance
Distinct areas of increase echogenicity
does not change contour of liver but appearas like mass
Cirrhosis cause
Parenchymal destruction, scarring, fibrosis and nodular regeneration
Cirrhosis clinical presentation (3)
Hepatomegaly (in early stages)
Jaundice
Ascites
cirrhosis lab tests
↗ AST, ALT, LDH
↗ Direct & indirect bilirubin
cirrhosis signs on ultrasound
Small liver (late stage) Surface nodularity Coarse/heterogenous echo Increased echo Signs of ascites, splenomegaly, portal hypertension
hepatic fibrosis is associated with
ARPKD
what is hepatic fibrosis
Excessive connective tissue build up due to chronic injury
clinical presentation of hepatic fibrosis (2)
Hepatomegaly
Portal hypertension
sono features of hepatic fibrosis (2)
increased echogenicity of liver
-biliary dilatation
4 hepatic vascular disorders
Portal Hypertension
Portal Vein Thrombosis
Budd-Chiari*
Hepatic Infarction
what is portal hypertension
Increased resistance to normal portal flow
clinical presentation of portal hypertension (5)
Splenomegaly Ascites Caput medusa In severe cases: Hematemesis Hepatic encephalopathy
3 types of obstruction leading to portal hypertension
Prehepatic (PV or spl. vein thrombosis)
Intrahepatic (cirrhosis)
Posthepatic (heart conditions)
sono features of portal hypertension (5)
Hepatofugal portal flow Varices Splenomegaly Ascities Cirrhosis
What two things can cause portal vein thrombosis
Can be caused by thrombosis due to dehydration, catheterization, shock or portal hypertension
or
tumor invasion from HCC or hepatoblastoma
clinical presentations of portal vein thombosis
- Acute abdo pain
- splenomegaly
sono features of portal vein thrombosis (6)
Enlarged, echogenic portal veins
Absent doppler
Vis tumor invasion
Cavernous transformation (in chronic PVT)
Acute PVT can mimic normal portal vein on grey scale ..why?
Collaterals
Budd-Chiari syndrome is clinical features of
features of hepatic venous outflow obstruction
causes of budd-chiari syndrome (3)
Idiopathic occlusion
Neoplastic invasion (Hepatoblastoma, HCC, Wilms tumor)
Thrombosis
sono findings of Budd-Chiari syndrome (6)
Primary findings
Hepatomegaly
Echogenic clot in HVs
Absence of flow in HVs
Secondary findings
Ascites
Pleural effusion
GB wall edema
Hepatic Infarction due to
hepatic blood supply, rare tho becuase of dual supply
can occur with hepatic artery occlusion
sono features of hepatic infarction
Wedge-shaped, round or oval area of decreased echogenicity
Good margins
Changes from hypo to hyper to calcification over time
most commonly injured abdominal organ in blunt abdominal trauma in children
liver lol
hepatic cysts associated with
multicystic kidney disease and Von Hippel Lindau disease
Can be acquired via trauma
Hydatid echinococcal cysts
Parasitic (tapeworm)
Echinococcus
Hydatid echinococcal cysts caused from
Exposure to livestock, farming, dogs
Parasite reaches liver from intestines through PV
Hydatid echinococcal cysts sono appearance
Simple cyst Complex cyst (daughter cysts, septa, debris, floating membranes)
Hydatid echinococcal cysts clinical signs (5)
Urticaria RUQ pain Hepatomegaly Lungs, brain, kidneys can be affected Rupture of cyst to peritoneum – anaphylactic shock
