MEDICAL BIOLOGY, HUMAN ANATOMY, PHYSIOLOGY AND PATHOLOGY - Ya.I. Fedoniuk 2010

ANATOMY, PHYSIOLOGY, PATHOLOGY

CHAPTER 7. THE NUTRITIONAL PROCESS AND ITS PATHOLOGY

PATHOLOGY OF THE DIGESTIVE SYSTEM

LIVER PATHOLOGY

1. LIVER FAILURE

Liver failure is a condition inซึ่ง the functional activity of the organ fails to maintain Homeostasis.

Liver failure can be absolute (if the decrease in function is caused by direct organ damage) or relative (if functional activity is inadequate to meet the body's demands).

Depending on the pathogenetic features, liver failure is classified into the following types: 1) hepatocellular (associated with dystrophic and necrotic lesions of hepatocytes); 2) excretory or cholestatic (resulting from impaired Bile formation and excretion); 3) vascular (caused by impaired hepatic Blood Circulation). However, functional liver failure typically involves a combination of several mechanisms. For instance, cholestasis may be accompanied by hepatocellular and vascular liver failure.

According to the degree of functional impairment, liver failure can be total (affecting all Functions) or partial (affecting specific functions); according to its clinical course, it is classified as acute or chronic.

Liver failure manifests as Central Nervous system dysfunction and various Metabolic Disorders. Consequences of inadequate vitamin assimilation include hemeralopia (impaired twilight Vision), cheilosis, glossitis, peripheral neuritis, and anemia.

Fever may be caused either by the underlying pathological process or by the impaired hepatic inactivation of pyrogenic substances.

Jaundice and Hyperbilirubinemia result from hepatocellular dysfunction. Portal Hypertension leads to ascites and edema. Hemorrhagic syndrome is caused by a deficiency in certain blood clotting factors and a reduced platelet count.

Chronic liver failure gradually leads to endocrine alterations. In men, these include signs of feminization (testicular atrophy, gynecomastia, female-pattern Hair distribution), whereas in women, they manifest as masculinization (Atrophy of the Uterus and Mammary Glands, menstrual irregularities). These changes are attributed to the impaired inactivation of Sex Hormones in the liver.