Liver
ACUTE ViRAL HEpATiTis atholo Although some histological features are suggestive of aetiological most of changes are essentially similar whatever the cause.
factor,
Features: -
Portal tract infiltration with inflammatory cells.
-
Swelling of hepatocytes intrahepatic cholestasis.
-
Centizonal necrosis (Zone 3).
~
narrowing
~linical J!icture
of bile canaliculi
~
I
I. Nan icteric hepatitis (Anicteric): -
It is usually a mild form of hepatitis, it may pass unnoticed. S bilirubin < 2.5 mg or < 3 mg. Clinically there is a mild flu-like illness with anorexia, nausea. Increased transaminases.
Fate -
Resolution, chronic hepatitis ~ post hepatitis liver cirrhosis !?
II-Icteric hepatitis: A - Pre-icteric phase -
(for about 1-2 weeks due to viremia)
Fever, headache, malaise. Marked anorexia, distaste for cigarettes. Pain in right hypochondrium. If you suspect you can confirm by rise of SGPT.
B- Icteric phase
(for about 3-6 weeks)
.~hQJ~.~.mt.j.~..J.~!!D.9.i~~ ..O.n.tm..h~I!~.t.j.~ ..~.b.QJ~搂~~j.~2 -
Swelling of hepatocytes ~ obliteration of bile canaliculus hepatic cholestasis ~ jaundice. - Dark urine. - Clay stool. - Improvement of fever, malaise, headache.
~
Intra
- Liver: mild++, Soft, tender (acute stretch of liver capsule). - Spleen: mild ++ = RES hyperplasia in 10% of patients.
~--------------------------~~,,~----, D.O. of just palpable spleen? Typhoid - Infective endocarditis - Viral hepatitis - Brucellosis - Infectious mononucleosis路