Histopathologic classification micronodular uniformly small nodules(<3 mm in diameter)and regular bands of connective tissue ● macronodu|ar 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
可中如酒画
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
2 Consequences of portal hypertension [ Il 1. Splenomegaly(脾肿大) 2. Formation and open of portal- systemic collaterals(门体侧支循环 开放) Esophageal/ gastric varices(食管/胃静脉曲张) (short gastric/coronary veins) Rectal collaterals(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 Liver Coronary Abdominal wall Omentum Abdominal nferie mesenterIc Epigastric spermatic vein Subcuta abdominal vein Superior haemorrhoidal vein nferior haemorrhoidal vein Vein of retzius Rectum