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Division of Liver blood flow and circulation
60-70% Portal vein
30-40% Hepatic artery
Peculiarity -> Blood flows from one capillary to the other (portal vein -> hepatic vein)
Liver lobule anatomy
No fibrous tissue
Which stain we need to use to highlight reticulin fibers?
Silver stain -> Reticulin network highlights liver cells plates/sinusoids and links centrilobular veins to portal tract
Liver failure description
-Most severe consequence of liver disease
-Can be acute or chronic
-Mortality: 80%
When do we have symptoms of Liver failure?
80-90% hepatic functional capacity loss
Therapy for Liver failure
Liver transplant
Difference between acute and chronic liver failure
Acute -> sudden and massive destruction
Chronic -> After decades of progressive liver injury
Acute ("fulminant") liver failure definition
Failure that occurs within 26 weeks of initial liver injury without pre-existing liver disease. Can be caused by massive hepatic necrosis (drugs -> acetaminophen; acute viral hepatitis A, B, E -> immune-mediated cell destruction; Toxins)
Clinical features of Acute Liver Failure
-Jaundice
-Ascites
-Fetor hepaticus (sweet fecal breath smell, "breath of the dead")
-Hypoalbuminemia
-Hypoglycemia
-Palmar erythema
-Spider angiomata
-Testicular atrophy
-Balding
-Gynecomastia
-Bleeding disorders
-Hepatorenal syndrome
-Hepatic encephalopathy
Gross appearance of Acute Liver Failure
Small, shrunken liver. Massive necrosis areas surrounded by regenerating hepatocytes. Scar formation and ductular reaction
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