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