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The periportal space (Latin: spatium periportale), or periportal space of Mall, [9] is a space between the stroma of the portal canal and the outermost hepatocytes in the hepatic lobule, and is thought to be one of the sites where lymph originates in the liver.
Ischemic hepatitis, also known as shock liver, is a condition defined as an acute liver injury caused by insufficient blood flow (and consequently insufficient oxygen delivery) to the liver. [5] The decreased blood flow ( perfusion ) to the liver is usually due to shock or low blood pressure.
Macroscopically, the liver has a pale and spotty appearance in affected areas, as stasis of the blood causes pericentral hepatocytes (liver cells surrounding the central venule of the liver) to become deoxygenated compared to the relatively better-oxygenated periportal hepatocytes adjacent to the hepatic arterioles.
Portal hypertension is defined as increased portal venous pressure, with a hepatic venous pressure gradient greater than 5 mmHg. [3] [4] Normal portal pressure is 1–4 mmHg; clinically insignificant portal hypertension is present at portal pressures 5–9 mmHg; clinically significant portal hypertension is present at portal pressures greater than 10 mmHg. [5]
Centrilobular necrosis (CN) is a nonspecific histopathological observation brought on by hepatotoxins like acetaminophen (paracetamol), [1] thioacetamide, tetrachloride, [2] cardiac hepatopathy due to acute right sided cardiac failure, and congestive hepatic injury in veno-occlusive disease, [3] or hypoxic injury due to ischemia. [2]
proper hepatic artery (entering) hepatic portal vein (entering) The hepatic duct lies in front and to the right, the hepatic artery to the left, and the portal vein behind and between the duct and artery. It also transmits nerves and lymphatics. Sympathetic nerves - these provide afferent pain impulses from the liver and gall bladder to the brain.
In the majority of acute liver failure (ALF) there is widespread hepatocellular necrosis beginning in the centrizonal distribution and progressing towards portal tracts. The degree of parenchymal inflammation is variable and is proportional to duration of disease. [7] [20] [21] Zone 1 (periportal) occurs in phosphorus poisoning or eclampsia.
The condition is commonly associated with vascular and cardiac changes associated with aging but can be caused by many other conditions, including congestive heart failure, kidney failure, liver cirrhosis, portal hypertension, trauma, alcoholism, altitude sickness, pregnancy, hypertension, sickle cell anemia, a compromised lymphatic system or merely long periods of time sitting or standing ...