The liver receives a quarter of its blood supply from the hepatic artery, which comes from the heart. The other three quarters of the blood supply coming from the portal vein, which empties into the intestines. The blood flowing out of the hose is filled with digested nutrients are processed in the liver.
The blood leaves the liver through the hepatic veins. The blood is a mixture of blood from the hepatic artery and portal vein blood. Hepatic vein empties into the vena cava, the largest vein in the body, which is then discharged into the heart.
Abnormalities of hepatic artery
Only the hepatic artery supplies the liver with the blood of some parts, especially the supporting tissue and bile duct walls.
Narrowing or blockage of arteries or its branches may cause significant damage to these areas. The flow may be interrupted artery injury, as piercing wound or surgical injury, or blood clot. Blood clots are generally caused by inflammation of the arterial wall (arteritis) or artery infusion of drugs against cancer or other toxic or irritating substances.
The aneurysm can damage the hepatic artery. Aneurysms are weak protuberance on the site in the artery, hepatic artery aneurysm is usually caused by infection, arteriosclerosis, injuries, or polyarteritis nodosa.
An aneurysm that compresses the adjacent bile duct it can be narrow or even block, and may develop jaundice as the bile from the liver back to back. Even you these aneurysms burst, often causing heavy bleeding. An aneurysm can be disposed in the insertion of the catheter and the hepatic artery mimicking an irritant substance that leads to clogging. If such a procedure (called embolization) fails, the artery is surgically repaired.
Veno-occlusive DISEASE
Constipation causes the return of blood to the liver, reducing liver blood supply. Lack of blood supply damages the liver cells.
Symptoms, prognosis and treatment
Blockage of small veins causes swelling of the liver with blood, making it sensitive to touch. The liquid can be iscjeđivati swollen liver from the surface and accumulate in the abdomen, creating a condition called ascites.
The return of blood to the liver and causes the increase of pressure in the portal vein (a condition called hypertension churchyards) in the veins, which empties into it. The higher pressure in the esophagus can cause varicose veins (esophageal varices), which can rupture and bleed.
Typically, the blockage disappears quickly, and people will recover with or without treatment. However, some people die of liver failure. For others, the pressure in the portal vein remains high and causes damage to liver cirrhosis.
The only treatment is the cessation of taking a substance or drug that caused the blockage. The actual course of the disease depends on the extent of damage and whether or not to be repeated. Chronic course, is more common, especially when the congestion caused by intake of herbal teas that contain toxic alkaloid.
Budd-Chiari syndrome
Budd-Chiari syndrome is a rare disease usually caused by blood clots that completely or partially clogged with large veins that drain into the liver.
The cause of Budd-Chiari syndrome is usually not known. Sometimes a person is in a condition that increases the likelihood of blood clots, for example. pregnancy or sickle cell disease (drepanocitoza). In rare cases, the veins are not actually blocked, but they are not due to congenital defects. Less than a third of people with Budd-Chiari syndrome survive a year without effective treatment.
Symptoms and diagnosis
Symptoms of Budd-Chiari syndrome can occur rapidly and be devastating, but usually appear gradually. The liver swell with blood and become sensitive. The liquid is drained from the surface of the liver swollen abdomen. There may be a pain in the abdomen and mild jaundice. The accumulation of blood in the liver raises the pressure in the portal vein, although the consequences, such as bleeding from varicose veins in the esophagus, not weeks or months to develop.
After several months may appear jaundice, fever and other symptoms of liver failure. Sometimes the blood clots that clog thus increase the lower part of the largest veins entering the heart (v. cava inferior, the lower vena cava).This blockage causes a significant swelling of the legs and abdomen.
Typical symptoms are a major key to diagnosis. Rtg veins that are made after the injection of funds radiokontrastnog accommodation can pinpoint blockages.
MRI can also help in diagnosis. Liver biopsy and ultrasound may help in differentiating between Budd-Chiari syndrome from similar diseases.
Treatment
If the vein is narrowed but not completely blocked, they can be used anticoagulants (drugs that prevent clotting), or thrombolytics (drugs that dissolve blood clots). In some cases, surgery may be made to connect the portal vein with a hollow venom and thus reduce the pressure in the hepatic portal vein bypass (hepatic by-pass). Liver transplantation may be the most effective treatment.
THROMBOSIS portal vein
Portal vein thrombosis is a blockage of the portal vein blood clot.
Constipation can cause cirrhosis or liver cancer, pancreas or stomach, or it can cause inflammation of the bile duct (cholangitis), inflammation of the pancreas (pancreatitis) or liver abscess. In newborns portal vein thrombosis may be due to infection of the navel (umbilicus). Portal vein thrombosis may occur in pregnant women, especially those with preeclampsia (a disorder that is characterized by high blood pressure, protein in urine, fluid retention, convulsions and sometimes coma).
Portal vein thrombosis can occur in any disorder that returns blood to the portal vein, such as Budd-Chiari syndrome, chronic heart failure or chronic pericarditis konstrikcijski. Also, portal vein thrombosis can cause abnormal blood clotting tendency. Often the cause of portal vein thrombosis can not be found.
Symptoms and diagnosis
Because veins churchyards provide you the blood supply of the liver, partial or complete blockage of the veins can damage liver cells, depending on where the clot is, how much and how quickly arises.
Constipation increases the pressure in the portal vein and other veins that flow into it. Increase the veins of the esophagus. Often the first symptom of portal vein thrombosis, bleeding from varicose veins of the esophagus (esophageal varices). The result is a bleeding coughing up or vomiting blood. Typically the increase in the spleen, especially in children with this disorder. The doctor may then feel (felt) enlarged spleen that may be sensitive to the touch.
In about a third of people with portal vein thrombosis, blockage occurs slowly, allowing blood to other channels (collateral channels) that are created around the blockage and finally re-opened the portal vein. Portal hypertension can exist despite the re-opening.
If a person has high blood pressure in the portal vein (portal hypertension) and microscopic examination of liver tissue samples showed that the cells are normal, portal vein thrombosis is the likely culprit. Constipation can be shown with or CT. Diagnosis is confirmed by angiography, X-ray technique that creates an image of veins after the portal vein injection of radiocontrast material.
Treatment
The aim of treatment is to reduce the pressure in the portal vein and prevent bleeding from varicose veins of the esophagus. The doctor may first try to close varicose veins using rubber bands or injections of these chemical substances applied through an endoscope (a flexible viewing tube with surgical attachments).
Surgery may be needed to create a connection (shunt) between the portal vein and vena cava, which will cause the blood passes by the liver and reduce the pressure in the portal vein. However, creating a bypass operation (shunt) increases the risk of hepatic encephalopathy (brain damage due to liver disease).
Vascular ARISING FROM OTHER DISEASES
• Hard to heart failure can cause elevated pressure in the veins that go from the liver.
This increased pressure can lead to liver damage. Treatment of heart failure often leads to recovery of liver function.
• In sickle cell disease (drepanocitoze), abnormally shaped red blood cells (erythrocytes) clog the blood vessels in the liver, causing her injury.
• Hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber disease) is an inherited disorder that can affect the liver. When the liver is affected in a small area it caused abnormally dilated blood vessels (telangiectasia). These abnormal blood vessels form a short circuit (shunts) between arteries and veins.
• Santa can cause serious heart disease that can damage and even harder to increase the liver. Blood flow in these compounds produces a loud continuous noise (noise) which can be heard stethoscope. Parts of the liver are altered scar (fibrosis and cirrhosis), and there are non-cancerous tumors composed of blood vessels (hemangiomas).
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