Disease – Liver, Gallbladder and Pancreas
Vienetta 32-65
1. Liver failure
o Acute liver failure
o Chronic liver failure and Liver cirrhosis
2. Viral hepatitis
o Acute hepatitis
o Chronic hepatitis
3. Alcoholic liver disease
4. Hepatocellular carcinomas
5. Gallbladder diseases
o Acute calculous cholecystitis
o Acute acalculous cholecystitis
o Chronic cholecystitis
6. Pancreas diseases
o Acute pancreatitis
o Chronic pancreatitis
o Pancreatic Carcinoma
Microarchitecture:
, • Hexagonal lobules
• The cords of hepatocytes
• Vascular sinusoids
• Bile canaliculi
The liver can be divided into three zones, based upon oxygen supply. Zone 1 encircles the portal
tracts where the oxygenated blood from hepatic arteries enters. Zone 3 is located around central
veins, where oxygenation is poor.
1. Liver failure
• Acute: no pre-existing liver disease.
• Chronic: pre-existing liver disease. (more common) (develop after 10 years)
Characteristics of liver change:
• Acute: massive hepatic necrosis.
• Chronic: chronic hepatitis to the end stage of cirrhosis.
•Mortality from liver failure without liver transplantation is 75% to 90%.
, Causes
• Viral hepatitis, drugs, toxins, severe fatty change (e.g. fatty liver of pregnancy, Reye
syndrome), vascular.
Clinical Course:
1. First manifestation:
Nausea, vomiting, and jaundice (skin) and icterus (sclera)
2. Following manifestations:
• Hepatic Encephalopathy 肝性腦病變: (brain disease)
spectrum of disturbances in consciousness. Caused by elevated ammonia level.
• Coagulation defects 凝固缺陷:
Impaired hepatic synthetic function, e.g. clotting factors
• Portal hypertension 門靜脈高壓症:
Caused by obstruction. More common in chronic liver failure.
Consequence: ascites and hepatic encephalopathy.
Chronic liver failure and Cirrhosis
Causes of chronic liver failure
• Chronic hepatitis B, chronic hepatitis C, non-alcoholic fatty liver disease, and alcoholic
liver disease
Cirrhosis 肝硬化:
▫Cirrhosis as the end-stage of chronic liver disease is defined by three characteristics:
• Bridging fibrous septa in the form of delicate bands or broad scars
• Parenchymal nodules containing proliferating hepatocytes encircled by fibrosis
• Disruption of the architecture of the entire liver
Vienetta 32-65
1. Liver failure
o Acute liver failure
o Chronic liver failure and Liver cirrhosis
2. Viral hepatitis
o Acute hepatitis
o Chronic hepatitis
3. Alcoholic liver disease
4. Hepatocellular carcinomas
5. Gallbladder diseases
o Acute calculous cholecystitis
o Acute acalculous cholecystitis
o Chronic cholecystitis
6. Pancreas diseases
o Acute pancreatitis
o Chronic pancreatitis
o Pancreatic Carcinoma
Microarchitecture:
, • Hexagonal lobules
• The cords of hepatocytes
• Vascular sinusoids
• Bile canaliculi
The liver can be divided into three zones, based upon oxygen supply. Zone 1 encircles the portal
tracts where the oxygenated blood from hepatic arteries enters. Zone 3 is located around central
veins, where oxygenation is poor.
1. Liver failure
• Acute: no pre-existing liver disease.
• Chronic: pre-existing liver disease. (more common) (develop after 10 years)
Characteristics of liver change:
• Acute: massive hepatic necrosis.
• Chronic: chronic hepatitis to the end stage of cirrhosis.
•Mortality from liver failure without liver transplantation is 75% to 90%.
, Causes
• Viral hepatitis, drugs, toxins, severe fatty change (e.g. fatty liver of pregnancy, Reye
syndrome), vascular.
Clinical Course:
1. First manifestation:
Nausea, vomiting, and jaundice (skin) and icterus (sclera)
2. Following manifestations:
• Hepatic Encephalopathy 肝性腦病變: (brain disease)
spectrum of disturbances in consciousness. Caused by elevated ammonia level.
• Coagulation defects 凝固缺陷:
Impaired hepatic synthetic function, e.g. clotting factors
• Portal hypertension 門靜脈高壓症:
Caused by obstruction. More common in chronic liver failure.
Consequence: ascites and hepatic encephalopathy.
Chronic liver failure and Cirrhosis
Causes of chronic liver failure
• Chronic hepatitis B, chronic hepatitis C, non-alcoholic fatty liver disease, and alcoholic
liver disease
Cirrhosis 肝硬化:
▫Cirrhosis as the end-stage of chronic liver disease is defined by three characteristics:
• Bridging fibrous septa in the form of delicate bands or broad scars
• Parenchymal nodules containing proliferating hepatocytes encircled by fibrosis
• Disruption of the architecture of the entire liver
