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Congestive hepatopathy, is liver dysfunction due to venous congestion, usually due to congestive heart failure.The gross pathological appearance of a liver affected by chronic passive congestion is "speckled" like a grated nutmeg kernel; the dark spots represent the dilated and congested hepatic venules and small hepatic veins.
Imaging tests such as transient elastography, ultrasound and magnetic resonance imaging can be used to show the liver tissue and the bile ducts. Liver biopsy can be performed to examine liver tissue to distinguish between various conditions; tests such as elastography may reduce the need for biopsy in some situations.
Ischemic hepatitis is related to another condition called congestive hepatopathy. Congestive hepatopathy includes a number of liver disorders that occur in right-sided heart failure. The medical term congestive hepatopathy is used, however, the term cardiac cirrhosis is convention. These two entities can coexist in an affected individual. [12]
Testing for chronic liver disease involves blood tests, imaging including ultrasound, and a biopsy of the liver. The liver biopsy is a simple procedure done with a fine thin needle under local anaesthesia. The tissue sample is sent to a laboratory where it is examined underneath a microscope. [3]
In congestive hepatopathy there are erythrocytes and a greater amount of fibrosis in the tissue surrounding the hepatic veins. [97] In primary biliary cholangitis, there is fibrosis around the bile duct, the presence of granulomas and pooling of bile. [98] Lastly in alcoholic cirrhosis, there is infiltration of the liver with neutrophils. [95]
Acute liver failure is the appearance of severe complications rapidly after the first signs (such as jaundice) of liver disease, and indicates that the liver has sustained severe damage (loss of function of 80–90% of liver cells).
Mild elevation of ALP can be seen in liver cirrhosis, hepatitis, and congestive cardiac failure. Transient hyperphosphataemia is a benign condition in infants, and can reach normal level in 4 months. In contrast, low levels of ALP is found in hypothyroidism, pernicious anemia, zinc deficiency, and hypophosphatasia. [6]
Doppler ultrasound of the liver is typically utilized to confirm or suggest the diagnosis. Common findings on liver doppler ultrasound include increased phasicity of portal veins with eventual development of portal flow reversal. The liver is usually enlarged but maintained normal echogenicity. A liver biopsy is required for a definitive diagnosis.