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CHAPTER 18

CHAPTER 18. LIVER & BILIARY TRACT. LIVER. Normal Pathology. GENERAL PATTERNS INFECTIOUS AUTOIMMUNE DRUG INDUCED/TOXIC METABOLIC. INTRAHEPATIC BILE DUCTS CIRCULATORY PREGNANCY ASSOCIATED TRANSPLANTATION RELATED TUMORS. PATHOLOGY. GENERAL FEATURES. PATTERNS HEPATIC FAILURE

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CHAPTER 18

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  1. CHAPTER 18 LIVER & BILIARY TRACT

  2. LIVER • Normal • Pathology

  3. GENERAL PATTERNS INFECTIOUS AUTOIMMUNE DRUG INDUCED/TOXIC METABOLIC INTRAHEPATIC BILE DUCTS CIRCULATORY PREGNANCY ASSOCIATED TRANSPLANTATION RELATED TUMORS PATHOLOGY

  4. GENERAL FEATURES • PATTERNS • HEPATIC FAILURE • CIRRHOSIS • PORTAL HYPERTENSION • JAUNDICE/CHOLESTASIS

  5. General Patterns

  6. Hepatic Failure

  7. Cirrhosis • Common Histologic Features • Fibrosis • Nodules • Clinical Features

  8. Portal Hypertension • Ascites • Portosystemic Shunts • Splenomegaly

  9. Jaundice/Cholestasis • Bilirubin/Bile Formation • Pathophysiology • Neonatal Jaundice • Hereditary Hyperbilirubinemia • Cholestasis • Familial Intrahepatic Cholestasis

  10. INFECTIOUS- VIRAL • Viral Hepatitis: • A, • B, • C, • D, • E • Other Viruses

  11. INFECTIOUS- VIRAL • Clinicopathologic Syndromes • Acute Asymptomatic with Recovery • Acute Symptomatic • Chronic Hepatitis

  12. INFECTIOUS- VIRAL • Morphology • Acute • Chronic • Fulminant

  13. INFECTIOUS- NONVIRAL • Bacterial • Parasitic • Helminthic

  14. HEPATITIS- AUTOIMMUNE

  15. HEPATITIS- DRUG/TOXIC • Alcohol • Alcohol • Alcohol • All Others

  16. HEPATITIS- DRUG/TOXICALCOHOL • Steatosis • Alcoholic Hepatitis • Cirrhosis

  17. METABOLICLIVER DISEASE • NON-Alcoholic Fatty • Hemochromatosis • Wilson Disease • α1-Antitrypsin Deficiency • Neonatal Cholestasis

  18. NON-AlcoholicFatty Liver

  19. Hemochromatosis

  20. Wilson Disease

  21. α 1-Antitrypsin Deficiency

  22. INTRAHEPATICBILE DUCT DISEASE • Secondary Biliary Cirrhosis • Primary Biliary Cirrhosis • Primary Sclerosing Cholangitis • Biliary Tree Anomalies and Cysts

  23. Secondary BiliaryCirrhosis

  24. Primary BiliaryCirrhosis

  25. Primary SclerosingCholangitis

  26. Biliary Tree Anomalies and Cysts • Von Meyenburg Complexes • Polycystic Liver • Congenital Hepatic Fibrosis • Caroli Disease

  27. CIRCULATORYDISORDERS • Impaired Flow INTO • Hepatic Artery • Portal System • Impaired Flow THROUGH • Hepatic Venous Obstruction

  28. Impaired Flow INTO • Arterial System • Portal System

  29. Impaired Flow THROUGH • Passive Congestion • Centrolobular Necrosis • Peliosis Hepatis

  30. Impaired Hepatic Vein OUTFLOW • Hepatic Vein Thrombosis • IVC Thrombosis • Veno-Occlusive Disease

  31. PREGNANCY-AssociatedDisorders • Preeclampsia • Eclampsia • Acute Fatty Liver • Intrahepatic Cholestasis

  32. TRANSPLANTATIONCOMPLICATIONS • Drug Toxicity • GVH (Graft Vs. Host) • NON-Immunologic Damage

  33. TUMORS • Nodular Hyperplasia • Benign • Malignant

  34. NODULAR HYPERPLASIA

  35. BENIGN TUMORS

  36. MALIGNANTTUMORS • Hepatocellular Carcinoma (Hepatoma) • Cholangiocarcinoma • Metastatic

  37. HEPATOCELLULARCARCINOMA

  38. CHOLANGIOCARCINOMA

  39. METASTATICTUMORS

  40. BILIARY TRACT • Normal • Pathology

  41. PATHOLOGY • Congenital • Gallbladder • EXTRA-Hepatic Bile Ducts • Carcinoma of the Gallbladder • Carcinoma of the EXTRA-Hepatic Bile Ducts • IATROGENIC INJURY to the BILIARY TREE

  42. GALLBLADDER • Cholelithiasis • Cholecystitis

  43. CHOLELITHIASIS • Prevalence • Risk Factors • Ethnic/Geographic • Age/Sex • Environment • Acquired • Hereditary Factors • Stones

  44. CHOLECYSTITIS • Acute • Chronic

  45. EXTRA-HEPATICBILE DUCTS • Choledocholithiasis • Biliary Atresia • Choledochal Cysts

  46. CHOLEDOCHOLITHIASIS/CHOLANGITIS

  47. BILIARY ATRESIA

  48. CHOLEDOCHAL CYSTS

  49. CARCINOMA of the GALLBLADDER

  50. CARCINOMA of theEXTRA-Hepatic Bile Ducts

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