Cirrhosis - Revision history

Michuang0720 at 19:25, 25 June 2016

2016-06-25T19:25:29Z

Bara: Text replace - "Biliary Tract - Obstruction" to "Biliary Tract Obstruction"

2013-05-14T13:18:42Z

Text replace - "Biliary Tract - Obstruction" to "Biliary Tract Obstruction"

Bara at 15:58, 3 September 2011

2011-09-03T15:58:21Z

Bara at 14:49, 22 August 2011

2011-08-22T14:49:59Z

Bara: /* Microscopically */

2011-08-22T14:46:01Z

Microscopically

Bara at 14:45, 22 August 2011

2011-08-22T14:45:30Z

Bara at 11:31, 18 August 2011

2011-08-18T11:31:35Z

Bara at 20:47, 28 June 2010

2010-06-28T20:47:06Z

Bara: Created page with 'a term often used for fibrotic lesions, especially widespread fibrosis it is an end stage liver with poor functional ability *much debate on the definition and classification o…'

2010-06-06T22:13:25Z

Created page with '*a term often used for fibrotic lesions, especially widespread fibrosis *it is an end stage liver with poor functional ability *much debate on the definition and classification o…'

New page

*a term often used for fibrotic lesions, especially widespread fibrosis
*it is an end stage liver with poor functional ability
*much debate on the definition and classification of cirrhosis
*in any case the following conditions prevail:
1. the whole [[Liver - Anatomy & Physiology|liver]] is involved

2. cellular necrosis occurs at some stage in the disease

3. there is nodular regeneration of liver cells

4. fibrosis occurs and is diffuse

5. there is disorganisation of the lobular architecture, with fibrous tracts joining portal triads and central veins

6. clinically it is a chronic disease

7. [[Liver - Anatomy & Physiology|liver]] cell failure always supervenes and portal hypertension is often a feature

===Aetiology===
*precise aetiology is unknown
*as in man, may be due to viral hepatitis in Rubarth's disease (ICH)

===Gross===
*smaller than normal
*firm to cut
**firmness is due to the presence of fibrous tissue
*pale, sometimes yellow in colour
*regenerating nodule
**can be small and even in size with the [[Liver - Anatomy & Physiology|liver]] having a finely granular appearance
**or much larger, uneven in size, and the [[Liver - Anatomy & Physiology|liver]] surface is deeply fissured and irregular
===Microscopically===
*exhibits all 3 responses to injury
**nodular regeneration of the parenchyma
***haphazard regeneration of liver cells forming islands of new cells surrounded by condensed portal areas
**fibrosis
***early cases show areas of fibrosis connecting two or more portal triads
***later cases have prominent laying down of cartilage
**biliary hyperplasia

===Effects of cirrhosis===
due to
*[[Liver - Anatomy & Physiology|liver]] cell failure
*development of portal hypertension
**displacement and compression of efferent veins
***fibrous connective tissue bands enclose veins and constrict them by contraction
***regenerating nodules of [[Liver - Anatomy & Physiology|liver]] cells contribute as well
**abnormal communications open up between arterial and venous branches
**this transmits high arterial pressure directly to the low pressure venous system

====Sequelae====
the rise in the venous pressure leads to the development of an accessory portal circulation and contributes to the development of ascites
*prominent collateral pathways form in an attempt to circumvent the portal obstruction
1. via the intercostal veins to the azygous

2. via the gastric veins through the oesophageal veins also to the azygous

3. various venous plexuses, draining back into the renal vein

4. several prominent subcutaneous veins are also seen, running radially from the umbilicus over the abdomen

NB: oesophageal and gastric collaterals in the dog run '''subserosal''', not '''submucosal''' like man, therefore they are not as subject to traumatic rupture
*ascites
**common finding
**other factors are involved: lowered plasma albumin, causing lowered colloid osmotic pressure[[Category:Liver_-_General_Pathology]]

← Older revision		Revision as of 19:25, 25 June 2016
Line 26:		Line 26:

	Cirrhosis is usually the end result of multiple pathological processes, in particular cell death and active inflammation with fibrosis. Regardless of the original underlying aetiology, however, the end-stage liver can no longer perform its functions, and is therefore associated with clinical manifestations of [[Liver Failure\|hepatic failure]].		Cirrhosis is usually the end result of multiple pathological processes, in particular cell death and active inflammation with fibrosis. Regardless of the original underlying aetiology, however, the end-stage liver can no longer perform its functions, and is therefore associated with clinical manifestations of [[Liver Failure\|hepatic failure]].
		+
		+	{{Learning
		+	\|Vetstream = [https://www.vetstream.com/canis/search?s=cirrhosis Cirrhosis]
		+	}}

	==References ==		==References ==

@@ Line 7: / Line 7: @@
 *Bile duct hyperplasia
-'''Bile duct hyperplasia''' around portal regions is a non-specific response to a variety of long-standing hepatic insults, but occurs especially in association with diseases that [[Biliary Tract - Obstruction|obstruct bile drainage]].
+'''Bile duct hyperplasia''' around portal regions is a non-specific response to a variety of long-standing hepatic insults, but occurs especially in association with diseases that [[Biliary Tract Obstruction|obstruct bile drainage]].
 '''Vascular abnormalities''' are also associated with cirrhosis. Anastomoses occur between the hepatic portal vein and systemic vasculature due to increased portal pressure. Additionally, [[Portosystemic Shunt|vascular shunts]] can result within regenerative nodules, either between central and portal veins, or  between hepatic arteries and central veins.
@@ Line 17: / Line 17: @@
 **[[Hepatitis, Lobular Dissecting|Lobular dissecting hepatitis in dogs]]
 **Hepatitis due to [[Infectious Canine Hepatitis|infectious canine hepatitis virus]]
-*Chronic [[cholangitis]] or [[Biliary Tract - Obstruction|bile duct obstruction]]
+*Chronic [[cholangitis]] or [[Biliary Tract Obstruction|bile duct obstruction]]
 *Chronic toxicity
 **[[Ragwort Toxicity|Pyrrolizidine alkaloid plants]] in herbivores

@@ Line 39: / Line 39: @@
+{{Nicky Parry
 [[Category:Liver_-_General_Pathology]]
-[[Category:Nicola Parry reviewing]]
+[[Category:Nicola Parry reviewed]]

@@ Line 1: / Line 1: @@
 ==Introduction==
-Cirrhosis represents an “end-stage liver” - the final, irreversible result of diffuse hepatic disease, involving architectural disruption of the entire liver. Underlying chronic injury leads to loss of hepatic tissue with replacement [[Liver Fibrosis|fibrosis]]. Nodular regeneration occurs within regions of hepatic tissue in between fibrous tissue bands, giving rise to the characteristic multinodular gross appearance of this condition.
+Cirrhosis represents an “end-stage liver” - the final, irreversible result of diffuse hepatic disease, involving architectural disruption of the entire liver. Underlying chronic injury leads to loss of hepatic tissue with replacement [[Liver Fibrosis|fibrosis]]. Nodular regeneration occurs within regions of hepatic tissue in between fibrous tissue bands, giving rise to the characteristic multinodular gross appearance of this condition. Overall, the liver is smaller than normal and firm to cut, firmness is due to the presence of fibrous tissue. It is pale, sometimes yellow in colour.
 The three characteristic microscopic features of cirrhosis are:
@@ Line 26: / Line 26: @@
 Cirrhosis is usually the end result of multiple pathological processes, in particular cell death and active inflammation with fibrosis. Regardless of the original underlying aetiology, however, the end-stage liver can no longer perform its functions, and is therefore associated with clinical manifestations of [[Liver Failure|hepatic failure]].
 ==References ==

@@ Line 33: / Line 33: @@
 ===Microscopically===
 The liver exhibits all 3 responses to injury:
-:nodular regeneration of the parenchyma - haphazard regeneration of liver cells forming islands of new cells surrounded by condensed portal areas
+*nodular regeneration of the parenchyma - haphazard regeneration of liver cells forming islands of new cells surrounded by condensed portal areas
-:fibrosis - early cases show areas of [[Liver Fibrosis|fibrosis]] connecting two or more portal triads, later cases have prominent laying down of cartilage.
+*fibrosis - early cases show areas of [[Liver Fibrosis|fibrosis]] connecting two or more portal triads, later cases have prominent laying down of cartilage.
-:biliary hyperplasia
+*biliary hyperplasia
 ==References ==

@@ Line 1: / Line 1: @@
 *a term often used for fibrotic lesions, especially widespread fibrosis
 *it is an end stage liver with poor functional ability
@@ Line 62: / Line 108: @@
 *ascites
 **common finding
-**other factors are involved: lowered plasma albumin, causing lowered colloid osmotic pressure[[Category:Liver_-_General_Pathology]]
+**other factors are involved: lowered plasma albumin, causing lowered colloid osmotic pressure
-[[Category:To_Do_-_Clinical]]

← Older revision		Revision as of 20:47, 28 June 2010
Line 63:		Line 63:
	**common finding		**common finding
	**other factors are involved: lowered plasma albumin, causing lowered colloid osmotic pressure[[Category:Liver_-_General_Pathology]]		**other factors are involved: lowered plasma albumin, causing lowered colloid osmotic pressure[[Category:Liver_-_General_Pathology]]
		+	[[Category:To_Do_-_Clinical]]