liver pathology power point Flashcards
Diffuse Liver Disease
affects the hepatocytes and interferes with liver function
Diffuse Liver Diseases
Fatty Liver Disease
Hepatitis
Cirrhosis
Portal Hypertension
Portal vein thrombosis
Budd-Chiari Syndrome
Fatty Infiltrate
An acquired and reversible disease
Benign
Increased lipid accumulation in the hepatocytes leading to impaired or excessive metabolism of fat
Clinical findings of Fatty Liver Disease
Asymptomatic
Alcohol abuse
Chemotherapy
Diabetes mellitus
Elevated liver function test
Obesity
Pregnancy
Sonograhic findings of Fatty Liver Disease
Diffusely echogenic liver
Liver may appear patchy, inhomogenous due to focal sparing
Liver is enlarged(hepatomegaly)
Increased attenuation of the sound beam
Walls of the hepatic vasculature and diaphragm will not be easily imaged(secondary to increased attenuation)
Compare the echogenicity of the right kidney to the liver.
Locations for Focal Fatty Sparing
Adjacent to the gallbladder
Near the porta hepatis
Entire medial segment of the left lobe
Can appear much like pericholecystic fluid when seen adjacent to the gallbladder
Hepatitis
Broadly defined as inflammation of the liver
Contracted through contact with fecal matter,contaminated food, body fluids, and blood.
Acute and Chronic
Results from infection by a group of viruses that specifically target the hepatocytes
Hepatitis types
Hep A(HAV)
Hep B(HBV)
Hep C(HCV)
Hep D (HDV)
Hep E (HEV)
Hep (HGV)
Hep A(HAV)
viral, spread primarily by feces since the virus lives in the alimentary tract. Found worldwide, accounts for 20% of cases. Acute
Hep B(HBV)
viral, spread by transfusions of infected blood or plasma or through contaminated needles. Can also be transmitted from body fluids. Greatest risk for Health Care workers, accounts for 60% of cases
Hep C(HCV)
viral, diagnosed by the presence in blood of the antibody to HCV. Seen mostly in Italy and other Mediterranean countries
Hep D (HDV)
viral, entirely dependent on HBV for its infectivity, rare in North America, seen primarily in IV drug users Must have HBV to aquire
Hep E (HEV)
viral, caused by fecally infected waters May be seen in liver transplantation
Hep (HGV)
viral, newly discovered, first described in 1996, caused by blood transfusion
Clinical findings of Hepatitis
Chills
Dark urine
Elevated liver function tests
Fatigue
Fever
Hepatosplenomegaly
Jaundice
Nausea
Vomiting
Sonographic findings of hepatitis
Normal liver
Enlarged, hypoechoic liver
Periportal cuffing with “starry sky”
Gallbladder wall thickening
Cirrhosis
Diffuse process characterized by fibrosis and conversion of normal liver parenchyma into structurally abnormal nodules
Generalized involvement of the liver by parenchymal necrosis, regeneration, and diffuse fibrosis
Scarring is progressive and irreversible leading to liver cell failure and portal hypertension
Cirrhosis-Continued
A leading cause of death in the US
Most common causeof micronodular cirrhosis is Alcohol Abuse. (.1-1.0 cm)
Most common cause of macronodular (1.0-5.0 cm) cirrhosis is Viral Hepatitis.
Other causes of cirrhosis include drug abuse,obesity,chronic bile retention, cardiac insuffiency,and some medications
Clinical findings of cirrhosis
Ascites
Diarrhea
Elevated liver function tests
Fatigue
Hepatomegaly(initial)
Jaundice
Splenomegaly
Weight loss
Sonographic findings of Cirrhosis
Hepatomegaly( initially)
Shrunken right lobe of the liver
Enlarged caudate and left lobe
Nodular surface irregularity
Coarse echotexture
Splenomegaly
Ascites
Monophasic flow within the hepatic veins
Hepatofugal flow within the portal veins