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Liver

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A. Hepatic vein outflow obstruction. 1. Budd-Chiari syndrome =Hepatic ... vera, pregnancy and the postpartum state, oral contraceptive use, PNH and intra ... – PowerPoint PPT presentation

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Title: Liver


1
Liver
2
Circulatory Disorders
A
B
c
3
  • A. Hepatic vein outflow obstruction
  • 1. Budd-Chiari syndrome Hepatic vein IVC
    thrombosis
  • Seen in Thrombotic conditions (polycythemia vera,
    pregnancy and the postpartum state, oral
    contraceptive use, PNH and intra-abdominal
    cancers - ex. hepatocellular carcinoma)
  • Membranous webs of IVC may give rise to
    obstruction
  • Characterized by Hepatomegaly, Ascites
    abdominal pain
  • Thrombosis of the major hepatic veins
  • extreme blood retention in the liver

4
  • 2. Veno-Occlusive Disease Jamaican bush tea
    (pyrrolizidine alkaloid), but now MC seen in
    bone marrow transplant recipients
  • Clinically similar to Budd-Chiari syndrome
  • marked deposition of collagen within the lumen of
    the central vein
  • B. Impaired Intra hepatic Blood flow
  • MCC cirrhosis
  • Other causes DIC (Eclampsia), sickle cell
    disease, Sarcoidosis
  • Passive Congestion and Centrilobular Necrosis
  • Peliosis Hepatis dilation of hepatic sinusoids
  • Exposure to anabolic steroids (rarely OCP and
    Danazol)
  • liver is mottled and blotchy with irregular
    blood-filled lakes
  • C. Impaired hepatic Blood in-flow
  • Portal vein obstruction
  • Thrombus

5
B Nutmeg
C- Infarct
  • Centrilobular hemorrhagic necrosis. (Nutmeg
    liver).
  • A thrombus is lodged in a peripheral branch of
    the hepatic artery
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