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81 Cards in this Set
- Front
- Back
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Incompatible with life
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Agenesis
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Anomalies of Position
the organs are reversed with the liver on the left and the spleen on the right |
Situs Inversus
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At least 45% of patients may have what variations?
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Vascular Anomalies
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What is vascular anomalies?
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the hepatic artery may have many variations as it arises from the celiac axis.
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Name the 3 variations?
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1. replaced left hepatic artery originating form the left gastric artery
2. replaced right hepatic artery originating from the sma 3. replaced common hepatic artery originating from the sma |
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What is the most common variation?
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the accessory vein drains the superoanterior segment of the right lobe
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This disease effects the hepatocytes and interferes with liver function.
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Diffuse hepatocellular disease
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What is a hepatocyte?
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parenchymal liver cell that performs all the functions of the liver
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What are the subcategories of diffuse parenchymal disease?
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fatty infiltration, acute and chronic hepatitis, early alcoholic liver disease, acute chronic cirrhosis
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This is an acquired, reversible disorder of metabolism resulting in an accumulation of triglycerides within the hepatocytes
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Fatty Infiltration
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How does the patient present with fatty infiltration?
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asymptomatic however some patients may present with jaundice, nausea, vomiting and abdominal tenderness or pain.
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Fatty infiltration is not always uniform throughout the liver parenchyma, some regions have increased echogenicity within a normal liver parenchyma.
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Focal fatty infiltration
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This condition should be suspected in patients who have masslike hypoechoic areas in typical locations in a liver that is otherwise increased in echogenicity
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Focal Sparing
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The general name for inflammatory and infectious disease of the liver, of which there are many causes
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Viral Hepatitis
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An acute infection that leads to either complete recovery or death from acute liver failure
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Hepatitis A
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How is Hepatitis A spread?
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spread primarily by fecal contamination because the virus lives in the alimentary canal
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Caused by the type B virus which exists in the blood stream and can be spread by transfusions of infected blood or plasma or through the use of contaminated needles
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Hepatitis B
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Which hepatitis has the greatest risk to health care workers?
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Hepatitis B
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Diagnosed by the presence in blood of the antibody HCV. Major health problem in Italy and other Mediterranean countries
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Hepatitis C
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This is entirely dependent on hepatitis B virus for its infectivity. Occur primarily in IV drug users
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Hepatitis D
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How long is recovery for acute hepatitis without complications?
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4 months
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What are the pathologic changes seen in acute hepatitis?
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1. liver cell injury, swelling of the hepatocytes and hepatocyte degeneration, which may lead to cell necrosis.
2. reticuloendothelial and lymphocytic resone with kupffer cells enlarging 3. regeneration |
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Exists when there is clinical are biochemical evidence of hepatic inflammation that extends beyond 6 months. Causes include those that are viral, metabolic, autoimmune or drug induced
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Chronic Hepatitis
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A chronic degenerative disease of the liver in which the lobes are covered with fibrous tissue, the parenchyma degenerates and the lobules are infiltrated with fat
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Cirrhosis
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How may cirrhosis be classified?
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1. micronodular (nodules 0.1 cm-1cm in diameter)
2. macronodular (nodules up to 5cm in diameter) |
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What happens at the end stage of cirrhosis?
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liver cell failure and portal hypertension
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Micronodular cirrhosis is the most common result of?
Macronodular cirrhosis is the most common result of? |
alcohol abuse
chronic viral hepatitis |
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How do patients present with acute cirrhosis?
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some asymptomatic but symptoms include nausea, flatulence, ascites, light colored stools, weakness, abdominal pain, varicosities, and spider angiomas
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How do patients with chronic cirrhosis present?
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symptoms include nausea, anorexia, weight loss, jaundice, dark urine, fatigue or varicosities
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Chronic cirrhosis may progress to what?
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liver failure and portal hypertension
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What is the first sonographic finding in the early stages of cirrhosis
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hepatomegaly
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This is an inherited disease characterized by the abnormal storage and accumulation of glycogen in the tissues, especially the liver and kidneys
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Glycogen Storage Disease
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This is a rare disease of iron metabolism characterized by excess iron deposits throughout the body
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Hemochromatosis
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Defined as an increase in portal venous pressure or hepatic venous gradient
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Portal Venous Hypertension
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The invasion of the portal system with tumor or thrombosis may cause what
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portal hypertension
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May develop secondary to trauma, sepsis, cirrhosis, or hepatocellular carcinoma
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portal vein thrombosis
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With U/S how does portal vein thrombosis present?
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shows absence of portal flow with echogenic thrombus within the lumen of the vein
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If portal hypertension becomes extensive what happens?
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the portal system can become decompressed by shunting blood to the systemic system
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What are the three types of shunts?
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portacaval, mesocaval and splenorenal
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This shunt attaches the main portal vein at the smv-splenic vein confluence to the anterior aspect of the IVC.
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portacaval shunt
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This shunt attaches the middistal superior mesenteric vein to the IVC
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mesocaval shunt
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This shunt attaches the splenic vein to the left renal vein
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splenorenal shunt
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This is an uncommon, often dramatic illness caused by thrombosis of the hepatic veins or IVC. Has a poor prognosis and is characterized by abdominal pain, massive ascites and hepatomegaly
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Budd-Chiari Syndrome
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What is the most characteristic clinical feature of Budd-Chiari Syndrome?
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Ascites
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This obstruction is proximal to the cystic duct and can be caused by gallstones, carcinoma of the CBD, or metastatic tumor or invasion of the porta hepatis
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Biliary obstruction: Proximal
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This obstruction is distal to the cystic duct may be caused by stones in the common duct, an extrahepatic mass in the porta hepatis, or stricture of the common duct
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Biliary obstruction: Distal
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Clinically how may a patient present with proximal biliary obstruction?
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Jaundice and may experience pruritus
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What are the sonographic findings for biliary obstruction proximal?
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carcinoma of the CBD appears as a tubular branching with dilated intrahepatic ducts
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What does the laboratory tests show with biliary obstruction proximal
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elevation in bilirubin and alp levels
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Clinically how may a patient present with distal biliary obstruction?
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RUQ pain, jaundice, pruritus
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What laboratory values will be elevated with distal obstruction?
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ALP, bilirubin
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What are the sonographic findings for distal biliary obstruction?
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dilated intrahepatic ducts are seen in the periphery of the liver
*Shotgun sign |
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Usually refers to a solitary nonparasitic cyst of the liver
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hepatic cyst
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Sonographic finding of a benign cyst show what?
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the lesion to be well demarcated, thin walled, and anechoic with posterior acoustic enhancement
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This disease is inherited in an autosomal dominant pattern that affects 1 in 500 individuals.
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Polycystic liver disease
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At least 50-74% of patients with polycystic disease have what?
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hepatic cysts
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Patients with polycystic liver disease 60% have what?
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associated polycystic renal disease
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How does the cyst appear in polycystic liver disease?
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the cysts are small less than 2-3 cm and multiple throughout the hepatic parenchyma
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How does the cyst appear on U/S?
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anechoic, well defined borders with acoustic enhancement
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Hepatic abscesses occur most often when
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complication of biliary tract disease, surgery or trauma
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A pus forming abscess
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pyogenic abscess
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What are some sources of infection
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cholangitis, diverticulitis, colitis
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Caused by a species of Candida. Usually occurs in immunocompromised hosts, organ transplant recipients, or HIV individuals.
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hepatic candidiasis
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How does hepatic Candidiasis spread?
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the candida fungus invades the bloodstream and may affect nay organ, with more perfused kidney, brain and heat
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A collection of pus formed by disintegrated tissue in a cavity, usually in the liver caused by the protozoan parasite
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Amebic abscess
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How is an amebic abscess contracted?
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through contaminated water and food.
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An infectious cystic disease common in sheep herding areas of the world. A tapeworm that infects humans as the intermediate host. The worm resides in the small intestine of dogs.
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Echinoccal cyst
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The most common organism causing opportunistic infection in patients with AIDS. It affects patients undergoing bone marrow and organ transplants or patients receiving chemo.
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Pneumocystis carinii
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Any new growth of new tissue either benign or malignant
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neoplasm
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A benign congenital tumor consisting of large blood filled cystic spaces.
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hemangioma
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The most common benign tumor of the liver its found more frequently in females
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Cavernous hemangioma
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A tumor of the glandular epithelium in which the cells of the tumor are arranged in a recognizable glandular structure . More common in women and has been related to oral contraceptives
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Liver cell adenoma
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the second most common benign liver mass after hemangioma. It is found in women under 40 yrs. Lesions occur more in the right lobe of the liver
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Focal Nodular Hyperplasia
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The most common tumor. Prevalence varies depending on predisposing factors such as Hep B and aflatoxin exposure.
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hepatocellular carcinoma
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High incidence of Hepatocellular carcinoma is linked to where?
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Africa, Japan, Greece, Italy and Southeast Asia
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The pathogenesis of hepatocellular carcinoma is related to
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cirrhosis
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Clinically patients with hepatocellular carcinoma present
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with a previous history of cirrhosis, Hep B and C, palpable mass, hepatomegaly, appetite disorder and fever
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The most common form of neoplastic involvement of the liver is
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metastatic disease
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The primary sites for metastatic disease are?
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colon, breast, and lung
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What are the 3 specific patterns that describe a metastatic tumor
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1. well defined hypoechoic mass
2. well defined echogenic mass 3. diffuse distortion of the normal homogeneous parenchymal pattern without focal mass |
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The most common indications for transplantation in adults is
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hep C followed by alcoholic liver disease
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