The Liver. Function: –Metabolism Anatomy/Histology –Right, left lobe –Biliary Tree –Components of Liver: 1. Liver Parenchyma (lobule) 2. Portal area (vessels,

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Presentation transcript:

The Liver

Function: –Metabolism Anatomy/Histology –Right, left lobe –Biliary Tree –Components of Liver: 1. Liver Parenchyma (lobule) 2. Portal area (vessels, bile ducts) 3. Vessels (portal and systemic circulation)

Pathology of Liver Primary vs Secondary disease Congenital/Genetic vs Acquired Neoplastic vs non-neoplastic Inflammatory diseases (infection, physical injury, chemical injury, ischemia, immune disease, metabolic disease) Hemodynamic disorder

Patterns of Hepatic Injury

Ballooning Degeneratin

Steatosis (macrovesicular)

Steatosis (microvesicular)

Feathery Degeneration

Iron deposition

Copper deposition

Interface Hepatitis

Protal inflammation

Piece-meal necrosis

Massive necrosis

Regenerative Nodules

Ductular Reaction

Bridging Fibrosis

Cirrhosis

Cirrhosis

Cirrhosis

Clinical Features of Liver Disease Hepatic Failure Cirrhosis Portal Hypertension Cholestasis

Clinical Features of Liver Disease Jaundice Hypoalbuminemia Hyperammonemia Plamar Erythema Gynecomastia Coagulopathy Hepatic encephalopathy

Clinical Features of Liver Disease History: –Pain, jaundice, Family history, Occupation, contact will jaundice patient, onset of illness –Fever, malaise, anorexia.. Examination: –Jaundice, pallor, Palmar erythema, Flapping tremor, –Ascites, liver enlargement, Spider nevi, Murphy’s sign

Investigations of Liver disease

Bilirubin Liver Enzymes: ALT, AST, GGT, Alk. Phosphatase Protein: Albumin, Globulin Imaging: ultrasound, CT scan..