PPT liver and billiary disease.pdf - The Liver Gallbladder and Biliary Tract Chapter 15 Dr M Khaba Outline of Lectures 1 Normal structure and func5on 2

PPT liver and billiary disease.pdf - The Liver Gallbladder...

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The Liver, Gallbladder and Biliary Tract Chapter 15 Dr M Khaba 21/06/2018
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Outline of Lectures 1. Normal structure and func5on 2. Pa8erns of hepa5c injury 3. Clinical syndromes Hepa5c failure Cirrhosis Portal hypertension Jaundice and cholestasis
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Outline of Lectures 4. Infec5ous and inflammatory disorders Viral hepa55s Hepa55s A/B/C/D/E Clinical features and outcomes of viral hepa55s Autoimmune hepa55s Pyogenic liver abscesses 5. Alcohol- and drug-induced liverdisease Alcoholic liver disease Drug-induced liver disease 6. Metabolic and inherited liver disease Nonalcoholic fa8y liver disease Inherited metabolic diseases Hemochromatosis Wilson Disease Alpha1 an5trypsin deficiency Neonatal cholestasis Reye Syndrome
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Outline of Lectures 7. Diseases of the intrahepa5c biliary tract ./ Primary biliary cirrhosis Primary sclerosing cholangi5s 8. Circulatory disorders Impaired blood flow into theliver Hepa5c artery inflow Portal vein obstruc5on and thrombosis Impaired blood flow through theliver Passive conges5on and cetrilobular necrosis Peliosis Hepa5s Hepa5c vein ouXlowobstruc5on Hepa5c vein thrombosis (Budd-Chiari syndrome) Sinusoidal obstruc5on syndrome 9. Pregnancy rela5ed liver disorders Preeclampsia & eclampsia Acute fa8y liver of pregnancy Intrahepa5c cholestasis of pregnancy 10. Tumours and hepa5c nodules Hepatocellular nodules Benign tumours Hepatocellular carcinomas
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Normal liver gross
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Normal liver The normal adult liver weighs 1400 to 1600gm. It has a dual blood supply. The portal vein providing 60% to 70% of [email protected] blood flow The [email protected] artery supplying the remaining 30% to 40%. The portal vein and the [email protected] artery enter the inferior aspect of the liver through the hilum, or portahepa)s .
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Cont. Within the liver , the branches of the portal veins, [email protected] arteries, and bile ducts travel in parallel within portal tracts , ramifying variably through 17 to 20 orders of branches.
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The most common terminology of the [email protected] microarchitectureis based on the lobular model The liver is divided into 1- to 2-mm in diameter lobules are oriented around the terminal tributaries of the [email protected] vein (terminal [email protected] veins) with portal tracts at the lobule’s periphery . These are oKen drawn as hexagonal structures.
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Cont. The hepatocytes in the vicinity of the terminal [email protected] vein are called “centrilobular” Those near the portal tract are “periportal.” Division of the parenchyma into “ zones” is a useful concept since certain types of [email protected] injury tend to [email protected] affect [email protected] zones .
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Lobule ! JJJ Cl) U') U') I' g! 0) C: (ti Cl) C: Cl) CL PV HA -------.::. , a L-.
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  • Fall '18
  • whites
  • Hepatology, chronic liver failure, liver disease

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