Diseases of the Liver

Diseases of the Liver, liver trauma, hepatic abscesses, liver cysts, hydatid cysts, nonparasitic liver cysts, benign tumors of the liver, adenoma, focal nodular hyperplasia, hemangioma, hemangioendothelioma, malignant tumors of the liver, hepatic metastates, primary hepatocellular carcinoma, portal hypertension, esophageal varices, gastric varices, ascites, hypoproteinemia, hypersplenism, portal vein occlusion, hepatic vein occlusion (budd-chiari syndrome), surgery of portal hypertension

Portal Hypertension

Elevation of pressure in the portal venous system may result from a number of intrahepatic and extrahepatic pathologic processes. However, in almost all instances portal hypertension is caused by obstruction. In most cases, the level of the obstruction is intrahepatic and is related to cirrhosis (alcoholic or posthepatitic). Other causes of portal hypertension include obstruction of the portal or splenic veins by carcinoma of the pancreas, pancreatitis, or inflammatory diseases of the retroperi-toneum, and high-viscosity low-flow states (e.g., polycythemia), which predispose to intravascular thrombosis. A less common cause is obstruction to the venous outflow of the liver (Budd-Chiari syndrome). Elevation […]

Malignant Tumors of the Liver

Primary Hepatocellular Carcinoma In the United States, primary liver cell carcinoma most commonly occurs in patients with underlying diffuse hepatocellular disease, especially alcoholic or postnecrotic cirrhosis. The clinical presentation varies from mild right upper quadrant discomfort and weight loss to hemorrhagic shock from massive intraperitoneal bleeding, which reflects rupture of the tumor into the peritoneal cavity, invasion of the biliary tree may produce obstructive jaundice. Although primary liver carcinoma is relatively infrequent in North and South America and Europe, the incidence of hepatocellular carcinoma is dramatically higher in Africa and Asia, where this tumor may account for up to one-third […]

Benign Tumors of the Liver

Adenoma Hepatic adenomas are benign lesions that generally are solitary and composed entirely of hepatocytes without Kupffer cells. The tumor has a strong hormonal association and most often occurs in women taking oral contraceptives. When seen in men, the tumor may be associated with hormonal therapy of carcinoma of the prostate. Spontaneous hemorrhage, sometimes of life-threatening proportions, is relatively common. The CT and ultrasound features of hepatic adenomas are nonspecific. On CT scans, the tumor appears as a low-den-sity or almost isodense mass that demonstrates a variable degree of enhancement. Recent hemorrhage appears as a central area of increased attenuation, […]

Liver Cysts

Hydatid Cysts Hydatid disease (echinococciasis) is a tissue infection of humans caused by the larval stage of a small tapeworm, most commonly Echinococcus granulosus. Dogs, sheep, cattle, and camels are the major intermediate hosts. The ova that are ingested by humans penetrate the intestinal mucosa and enter the portal circulation. Most are filtered out by the liver or lui.g, but some escape into the general circulation to involve kidney, bones, brain, and other tissues. The larvae that are not destroyed develop into hydatid cysts, which have a double wall composed of a thick outer membrane (exocyst) and a thin inner […]

Hepatic Abscesses

Hepatic abscesses are related to two distinct groups of pathogens, pyogenic bacteria and Entamoeba histolytica. Pyogenic abscesses of the liver result from such diverse causes as ascending biliary tract infection (especially secondary to calculi or carcinoma in the extra-hepatic biliary ductal system); hematogenous spread via the portal venous system; generalized septicemia with involvement of the liver by way of the hepatic arterial circulation; direct extension from intraperitoneal infection; and hepatic trauma. Pyogenic abscesses may be solitary, multiple, or multilocular. A single abscess is usually located in the right lobe. I lepatic abscesses are the most frequent extracolonic complication of amebiasis, […]

Liver Trauma

Liver Trauma, subcapsular hepatic hematoma

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