Skip to main content Accessibility help
×
Hostname: page-component-7c8c6479df-995ml Total loading time: 0 Render date: 2024-03-28T15:18:06.139Z Has data issue: false hasContentIssue false

8 - Pathology of acute liver failure

from Part Two - Mechanisms of Disease and Multisystem Involvement

Published online by Cambridge University Press:  20 May 2010

William M. Lee
Affiliation:
University of Texas Southwestern Medical Center, Dallas
Roger Williams
Affiliation:
University College London
Get access

Summary

INTRODUCTION

Confluent necrosis and loss of liver parenchyma in either zonal or nonzonal distribution is the commonest pathology underlying acute liver failure. More rarely microvesicular fatty change in the absence of significant parenchymal loss, or another pathology may dominate the histologic picture and indicate the likely etiology. When confluent necrosis does occur, there is usually a lack of specificity of pathologic features. However, different patterns of damage may reflect different etiology and/or disease duration and prognosis and at times influence management and likelihood of recovery.

In this chapter, the terminology and main patterns of liver necrosis are reviewed and then related to the various causes of liver failure. The morphologic changes associated with some rarer causes, in particular Wilson's disease, Budd–Chiari syndrome, malignant infiltration, as well as those of liver failure following orthotopic liver transplantation and in the immunocompromised host are discussed separately. The section ends with some considerations on liver regeneration as observed in human liver after severe necrosis, with the experimental aspects of regeneration being treated in the next chapter.

CONFLUENT PARENCHYMAL NECROSIS

Forms of confluent liver necrosis

Necrosis and/or loss of confluent areas of parenchyma show a variety of patterns which depend on: their distribution in relation to both the acinar architecture and the liver as a whole; whether or not cell dropout has taken place; and the degree and distribution of the regeneration process.

Macroscopic examination

Previously, information about the gross appearances of the liver in acute hepatitis were obtained from laparoscopic views in nonfatal cases and at autopsy in cases of fulminant failure.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×