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| Chronic Passive Congestion | ||
| Etiology •Any disease that results in right heart failure can cause chronic passive congestion of the liver. | ||
| Pathogenesis • Right heart failure results in delayed emptying of the great veins and retention of blood primarily in the central veins of the liver. • This results in dilatation of central veins and pooling of blood in the sinusoids towards the center of the liver lobule., | ||
| Epidemiology •Common. | ||
| General Gross Description • Grossly, the liver is enlarged, deep red and somewhat soft. • The lesion can be palpated clinically by an enlarged liver with characteristically rounded edges. • On cut surface, the liver oozes a considerable amount of blood. • The contrast between the central congested sinusoidal space the peripheral paler areas, often with some evidence of fatty change, results in a striking appearance referred to as a "nutmeg" liver, since it resembles a bisected nutmeg. •Examples: | ||
| General Microscopic Description • The lesion is characterized by distended central veins full of blood, and congestion of sinusoids in the centrilobular area. •Examples: | ||
| Clinical Correlation • Aside from the enlargement of the liver, chronic passive congestion has no clinical significance. • If the lesion develops acutely with centri-lobular necrosis, some evidence of liver cell death in the form of elevated transaminases may be seen. | ||
| References • Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 872-873. • Harrison's Principles of Internal Medicine, 13th Ed: Isselbach et. al. (eds). New York, McGraw-Hill, 1994, pp. 1489. Please be patient during transfer. Medline will open in a new window. To return, close the Medline Window Chronic Passive Congestion
| Synopsis by: T.V.Rajan, M.D., Ph.D. (T56000M36142)[487]
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