Liver congestion
Introduction
Introduction Hepatic stasis refers to the return of blood from the liver to the heart through the posterior vena cava, which is blocked by some reasons, causing the blood to stagnant in the hepatic vein. The congestion spreads from the central vein of the hepatic lobules to the hepatic sinus, and the surrounding hepatocytes undergo atrophy, degeneration and necrosis due to stress, malnutrition and insufficient oxygen supply. The blood enters these parts, making the center of the hepatic lobules dark red, and the periphery is pale pink, forming the so-called cardamom liver. Hepatic congestion causes congestion of the portal vein and the cava of the portal vein, leading to the production of ascites.
Cause
Cause
1. Liver tumors, abscesses, cysticercosis, and swollen lymph nodes cause the hepatic vein to be compressed.
2. A thrombus is formed in the hepatic vein or its branches.
3. Heart disease and heart valve disease with incomplete heart function.
4. A lung disease that causes incomplete heart function.
5. Heart disease with left ventricular insufficiency.
6. Cycling disorders caused by parasitic mites.
Examine
an examination
Related inspection
Liver ultrasonography, a kind of fetal globulin test, hepatic texture, upper and lower hepatic perfusion, hepatic-jugular regurgitation
Clinical manifestations:
1. Liver enlargement: Due to congestion, the amount of blood in the liver increases, and the size and weight of the liver increase. The liver that is not accessible at the trailing edge of the rib arch at normal time can be touched at this time.
2. Increased ascites: due to hepatic congestion, portal veins and portal veins in the intestine, mesentery, omentum, etc. In addition, lesions of hepatocytes reduce albumin synthesis and decrease plasma osmotic pressure. For these reasons, leakage of ascites is increased.
3. Vomiting: Hepatomegaly and increased ascites cause the stomach to be compressed, causing vomiting.
4. Various symptoms presented during congestive heart failure.
5. The spirit is sluggish.
6. Loss of appetite.
7. Weight loss.
Clinical pathology:
1. Increased serum enzyme activity in the liver: Degeneration and necrosis of hepatocytes due to congestion, release of GPT, GOT and arginase in the cells into the blood, and the activity of these enzymes in the blood is increased.
2. Bile stasis causes -GTP, ALP and bilirubin to rise. The above two types can also be found in other liver diseases, and need to be identified in combination with clinical symptoms.
Diagnosis
Differential diagnosis
Liver ascites: cirrhosis ascites commonly known as liver ascites. Normal people have a small amount of free ascites in the abdominal cavity, usually about 50 ml, which plays a role in maintaining the lubrication between organs. When there is too much free liquid in the abdominal cavity, it is called ascites. Cirrhosis ascites is a chronic liver disease. From large, nodular, diffuse hepatic changes, necrosis, regeneration; regeneration, necrosis, promote tissue fibrosis and scar contraction, resulting in liver hardening, cirrhosis. Liver cirrhosis caused by portal hypertension, resulting in splenomegaly, protein fluid leaking from the absorption of protein and vitamins, formed ascites.
Identification:
1. Hepatic rupture of the hepatic membrane: rupture under the capsule, rupture of the liver parenchyma under the capsule, forming a subdural hematoma is a kind of liver rupture, and liver rupture refers to liver rupture caused by blunt action. Since the external force acts directly on the liver area, the liver is squeezed between the anterior and posterior abdominal wall and the spine, or the body can be damaged by acceleration, deceleration, and torsion during exercise.
2, liver fat: the lipid droplets appearing in the cytoplasm exceed the physiological range, or fat droplets appear in cells that do not normally appear lipid droplets, which is called fat change. The liver is the main organ of fatty acid metabolism, and liver fat is more common. In severe cases, almost all liver cells undergo fatty changes, liver enlargement, mild tenderness and abnormal liver function, called fatty liver.
diagnosis:
1. Liver enlargement: Due to congestion, the amount of blood in the liver increases, and the size and weight of the liver increase. The liver that is not accessible at the trailing edge of the rib arch at normal time can be touched at this time.
2. Increased ascites: due to hepatic congestion, portal veins and portal veins in the intestine, mesentery, omentum, etc. In addition, lesions of hepatocytes reduce albumin synthesis and decrease plasma osmotic pressure. For these reasons, leakage of ascites is increased.
3. Vomiting: Hepatomegaly and increased ascites cause the stomach to be compressed, causing vomiting.
4. Various symptoms presented during congestive heart failure.
5. The spirit is sluggish.
6. Loss of appetite.
7. Weight loss.
Pathological changes:
1. Increased serum enzyme activity in the liver: Degeneration and necrosis of hepatocytes due to congestion, release of GPT, GOT and arginase in the cells into the blood, and the activity of these enzymes in the blood is increased.
2. Bile stasis causes -GTP, ALP and bilirubin to rise. The above two types can also be found in other liver diseases, and need to be identified in combination with clinical symptoms.
