Histopathologic classification micronodular uniformly small nodules (<3 mm in diameter)and regular bands of connective tissue macronodular nodules that vary in size(3 mm to 5 cm in diameter) mixed macro and micronodular (incomplete septal cirrhosis)combines elements of micronodular and macronodular cirrhosis
Histopathologic classification • micronodular uniformly small nodules (< 3 mm in diameter) and regular bands of connective tissue • macronodular nodules that vary in size (3 mm to 5 cm in diameter) • mixed macro and micronodular (incomplete septal cirrhosis) combines elements of micronodular and macronodular cirrhosis
Portal Hypertension-Pathogenesis Pressure Flow x Resistance Increased resistance (Fixed/Modulable Factors) Increased flow (Splanchnic Vasculature Fixed Modulable Intrahepatic Nodules Stellate cell resistance ?organ contraction contraction organ contraction Rockey, 1999
Consequences of portal hypertensionI 1. Splenomegaly(脾肿大) 2. Formation and open of portal systemic collateral's(门体侧支循环 开放) Esophageal/ gastric varices(食管/胃静脉曲张) (short gastric/coronary veins) Rectal collateral(痔静脉丛) (Suphemorrhoidal /middle inf hemorrhoidal) Caput medusae((水母头)( umbilical/ epigastric - abdominal wall varices(腹壁静脉曲张) Portal system and left renal
Consequences of portal hypertension[I] 1.Splenomegaly (脾肿大) 2.Formation and open of portalsystemic collateral’s (门体侧支循环 开放) --Esophageal/gastric varices (食管/胃静脉曲张) (short gastric/coronary veins) --Rectal collateral‘s(痔静脉丛) (Suphemorrhoidal/middle & inf. hemorrhoidal) --Caput medusae(水母头)( umbilical/epigastric) --abdominal wall varices (腹壁静脉曲张) --Portal system and left renal
Diaphragm Veins of Sappey Oesophageal varices Stomach Coronary Para-umbilical te Abdominal Omentum Abdomina wall Inferior Spleen Epigastric matic vein Subcutaneous abdominal vein Superior haemorrhoidal vein Inferior haemorrhoidal vein Vein of retzius