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Abdomen > Liver Pathology > Flashcards

Liver Pathology Flashcards

1
Q

Abnormal retention of lipids

A

Steatosis

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2
Q

In the general pathological process stress is created whenever there is the change in
If the source of stress is not removed what will happen

A

Environment internally or externally
Cell will go through degenerative changes eventually death

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3
Q

What happens during cellular adaptions

A

Changes the cell makes in order to adjust to stress

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4
Q

Enlargement of cells and increases BP requiring heart to do more work and leads to cardiomegaly

A

Hypertrophy

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5
Q

Increase in amount of cells and will increase demand

A

Hyperplasia

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6
Q

Decrease in cell size

A

Atrophy

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7
Q

Transformation of one cell type to a less specialized type

A

Metaplasia

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8
Q

What are 3 examples of cellular degenerations

A

Swelling
Fatty infiltration
Cell necrosis

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9
Q

Water accumulation within the cells

A

Swelling

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10
Q

Droplets of fat accumulates within cell and liver is often affected due to its role in fat metabolism

A

Fatty infiltration

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11
Q

Death of cells and enzymes are released that digest dead cells

A

Cell necrosis

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12
Q

What are 5 examples of liver pathology

A

Diffuse disease
Parenchyma abnormalities
Focal disease
Masses
Portal hypertension

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13
Q

What are 5 examples of diffuse hepatocellular disease

A

Fatty infiltration
Glycogen storage disease
Hemochromatosis
Hepatitis
Cirrhosis

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14
Q

Fatty infiltration is what type of disorder
Is an abnormal ? And can interfere with ?
Commonly seen on ?

A

Non-specific reversible metabolic disorder
Abnormal accumulation of fat within hepatocytes
Commonly seen in U/S

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15
Q

Fatty infiltration can be corrected by

A

Correction/treatment of primary problem will reverse the process

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16
Q

What are the causes of fatty infiltration

A

Obesity
Excessive alcohol consumption
Hyperlipidemia
Diabetes
Pregnancy
Chronic hepatitis
Cystic fibrosis
Chemotherapy

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17
Q

Diffuse fatty infiltration increases ?
And if difficult to?

A

Echogenicity and attenuation of sound beam
Visualize parenchyma, vessels and diaphragm

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18
Q

What does mild diffuse fatty infiltration look like sonographically

A

Mild increase in echogenicity

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19
Q

What does moderate diffuse fatty infiltration look like sonographically

A

Difficulty visualizing parenchyma and diaphragm

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20
Q

What does severe diffuse fatty infiltration look like sonographically

A

Marked increase in echoes, non-visualization of vessels diaphragm

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21
Q

In focal fatty infiltration there is an increase in
Usually occurs near
Might mimic
Can show rapid

A

Increase in focal area echogenicity
Near porta hepatis
Mimic neoplasm
Rapid change with time

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22
Q

The focal area in focal fatty sparing the liver
How does it appear sonographically
Commonly occurs in ___ near ___

A

Does not demonstrate fatty infiltration
Hypoechoic area within echogenic liver
Occurs in caudate lobe near porta hepatis

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23
Q

How can you differentiate focal fatty sparing and focal fatty infiltration

A

Look for mass effect
Normal TSC scan
Areas of low attenuation on CT scan

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24
Q

What is glycogen storage disease

A

Congenital enzyme deficiency affecting glycogen metabolism

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25
Q

Glycogen storage disease has large amount of ?
Has stunted ?
___ may lead to convulsions
__% mortality

A

Large amount of glycogen deposited in hepatocytes and kidneys
Stunted growth and platelet dysfunction
Hypoglycemia may lead to convulsions
50% mortaility

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26
Q

GSD usually appears silimar to ?
How does it appear similar

A

Similar to diffuse fatty infiltration
By:
- Hepatomegaly
- Enalrged kidneys

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27
Q

GSD may also present what type of masses
How do they appear sonographically

A

Focal solid masses (Adenomas)
Round, echogenic, homogenous

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28
Q

Wha is hemochromatosis
Who is more at risk
What are these patients at higher risk for

A

Excessive accumulation of iron within the liver
Males more at risk (7:1)
Increased risk for HCC

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29
Q

T or F
Hemochromatosis is not a hereditary disease

A

False
Is a hereditary disease

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30
Q

How will hemochromatosis be seen on ultrasound

A

Diffuse increased echogenicity
Attenuation with hepatomegaly
Indistinguishable from fatty infiltration

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31
Q

What is the treatment for hemochromatosis

A

Weekly removal of the blood

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32
Q

For hemochromatosis with screening and early detection patients will

A

Have a normal life expectancy

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33
Q

What is hepatitis
What is it caused by
What can this lead to

A

Inflammation of hepatocytes
Caused by various viruses, drugs, chemicals, and alcohol
Lead to liver failure and death

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34
Q

What are the symptoms of hepatitis

A

Some will not exhibit clinical symptoms
Loss of appetite
Malaise
Jaundice
Abnormal LFT’s

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35
Q

What are the types of hepatits

A

Drug induced
A, B, C, D, E
Acute
Chronic

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36
Q

How is Hep A transmitted
What is the recovery rate

A

Transmitted via fecal-oral route
99% recovery with antibodies

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36
Q

You can have hepatitis but still have a normal

A

Normal liver scan

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37
Q

Which types of hepatitis are transmitted via blood/body fluis

A

Hep B, C, and D

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38
Q

For Hep B, C, and D you can be a ?
Can progress to ?
Patients with these have increases risk of?

A

Can be a carrier and transmit to others
Can progress to chronic liver failure
Increased risk of HCC

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39
Q

You must have Hep ___ to get Hep B

A

Must get Hep D to get Hep B

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40
Q

Hep E is similar to ?
Common in ?
Transmitted via

A

Similar to Hep A
Common in India, Asia, and Africa
Transmitted via blood/body fluids

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41
Q

What is a characteristic of drug induced hepatitis

A

Clinically and histologically indistigushable from viral hepatitis

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42
Q

What are the clinically manifestations of hepatitis

A

Uncomplicated acute hepatitis
Fulminant

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43
Q

Uncomplicated acute hepatitis have full ___ and usually result from

A

Full recovery
Result of Hep A

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44
Q

What falls under the fulminant clinical manifestation for hepatitis

A

Hepatic failure (Possible death)
Jaundice
Coagulopathy
Hepatic encephalopathy
Chronic hepatitis

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45
Q

Most cases of hepatitis

A

Drug induced toxicity or Hep B

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46
Q

What is chronic hepatitis

A

Persistence of hepatitis for longer than 6 months

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47
Q

What is the treatment for hepatitis

A

Prognosis, treatment of chronic hepatits depends on the etiology

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48
Q

What is the sonographic acute hepatitis

A

Decreased echogenicity
Increased brightness of portal triad walls (Starry sky appearance)
Hepatomegaly
GB wall thickening

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49
Q

What is the sonographic appearance of chronic hepatitis

A

Hepatic parenchyma progressively damaged
Visualized as course texture, hetergenous, decreased size

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50
Q

Irreversible liver damage that replaces normal liver architecture with abnormal fibrosis nodules

A

Cirrhosis

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51
Q

With cirrhosis as hepatocytes attemot to regenerate ?
Leads to ?
Replacement of ?

A

They surround with fibrosis
Leads to scarring of liver tissue
Replacement with fibrotic nodules

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52
Q

What are the classifications of of cirrhosis by size of nodules
What are the most common causes of these classifications

A

Micronodular <3 mm
- Alcoholism
Marconodular >3 mm
- Chronic viral hepatitis

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53
Q

What are the causes of cirrhosis
What percentage are these causes?

A

Alcoholic liver disease - 70%
Viral hepatitis - 10%
Biliary causes - 10%
Hemochromatosis - 5%
Other - 5%

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54
Q

What are the 3 types of alcoholic liver disease

A

Fatty infiltration
Alcoholic hepatits
Alcoholic cirrhosis

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55
Q

T or F:
Fatty lnfiltration is irreversible

A

False
Is reversible

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56
Q

Alcoholic hepatits may resolve or progress ?
May not have ?

A

Chronic liver disease
May not have any clinical symptoms

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57
Q

What is associated with alcoholic cirrhosis

A

Portal hypertension
Ascites
Jaundice

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58
Q

What are the clinical symptoms of alcoholic liver disease

A

Anorexia
Indigestion
Nausea/vomiting
Diarrhea/constipation
Abdominal pain
Abnormal bleeding
Edema/ascites
Jaundice
Fatigue
Hepatic encephalopathy

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59
Q

When you have abnormal LFT’s you could have an increase in?
Decrease in?

A

I - PT time, AST/ALT, Bilirubin
D - Total protein, albumin

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60
Q

What is primary biliary cirrhosis?
Destructs?
Causes what to the portal vein?
Leads to ?

A

Chronic, progressive often fatal form of cirrhosis
Destructs intrahepatic bile ducts
Causes wall inflammation and scarring
Leads to liver failure and itchy skin

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61
Q

What is secondary biliary cirrhosis

A

Periportal secondary to prolonged obstruction of an extrahepatic biliary tree

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62
Q

What are the sonographic findings of cirrhosis

A

Volume redistribution - Liver becomes small, shrunken with enlargement of the CL (CL/RL Ratio = 0.65)
Course texture - Increased echogenicity, inhomogeneity

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63
Q

What are the sonographic patterns of cirrhosis

A

Nodular surface with easily visible with surrounding ascites
Regeneration nodules may mimic neoplasm

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64
Q

What are the associated sonographic findings of secondary biliary cirrhosis

A

Ascites
Pancreatitis
Narrowed HV’s, and/or IVC by nodular regeneration
Portal hypertension recanalized in the umbilical vein
Cirrhosis

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65
Q

T or F
Ligamentum teres should not have blood in it

A

True

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66
Q

Bile pigment formed from the hemoglobin portion of destroyed RBC’s

A

Bilirubin

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67
Q

Where does bilirubin happen in the body

A

Liver
Spleen
Bone marrows

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68
Q

Unconjugated/indirect bilirubin

A

Inital non-water soluble that must be carried through blood by albumin

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69
Q

Bilirubin is carried to the ___ and taken up by the ____

A

Carried by the liver and taken up by hepatocytes

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70
Q

Liver converts indirect bilirubin into

A

Direct/conjugated bilirubin

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71
Q

Hepatocytes secrete direct bilirubin into the ?

A

Secrete direct bilirubin into the bile canaliculi in the lobules

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72
Q

Jaundice has elevated levels of

A

bilirubin in the blood and tissues

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73
Q

What are the 2 types of jaundice

A

Medical/Non-obstructive and surgical/onstructinve jaundice

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74
Q

What are the characterisitcs associated with hemolytic jaundice

A

Abnormally large RBC’s being destoryed
Elevated indirect bilirubin
Hepatocytes can’t handle quantity

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75
Q

What is hepatocelluar jaundice
What is elevated

A

Due to hepatocyte inflammation or fibrosis bile cannot properly be excreted into bile canaliculi
Direct bilirubin is elevated

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76
Q

What is surgical jaundice
What can cause it
What is elevated

A

Obstruction of bile outflow
Causes:
- Stone in CBD
- Mass in CBD, head of pancreas or duodenum
- Inflammatory stricture
Direct bilirubin is elevated

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77
Q

What are the parenchyma abnormalities

A

Proximal biliary obstruction
Distal biliary obstruction
Extrahepatic mass
Common duct stricture
Passive hepatic congestion

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78
Q

In the proximal biliary obstruction where is the obstruction located

A

Proximal to the cystic duct

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79
Q

What are the symptoms of proximal biliary obstruction

A

Jaundice
Pruritis
Elevated bilirubin and alk phos

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80
Q

What are the sonographic findings of proximal biliary obstruction

A

Normal GB even after food
Dilated ducts in liver periphery

81
Q

Where is the obstruction in a distal biliary obstruction located
And what is the most common thing found in the common dust

A

Distal to the cystic duct
Mass or stones

82
Q

What are the symptoms of distal biliary obstruction

A

RUQ pain
Jaundice
Pruritis

83
Q

What are the sonographic findings associated with distal biliary obstruction

A

Small GB
Enlarged intrahepatic ducts
Stones may be present in GB and/or duct

84
Q

What is an extrahepatic mass

A

A mass in the area of the porta hepatis

85
Q

What are the possible sources of an extrahepatic mass

A

Pancreatitis or carcinoma
Lymph nodes
Pseudocyst

86
Q

What are the sonographic findings of an extrahepatic mass

A

Irregular, ill defined, hypoechoic mass
Intrahepatic bil dil

87
Q

What are the symptoms of a common duct stricture

A

Previous cholecystectomy
Jaundice
Increased bilirubin and alk phos

88
Q

What are the sonographic findings of common duct stricture

A

Intrahepatic bil dil
No mass in the porta hepatis

89
Q

What is passive congestion

A

Congestion due to heart failure

90
Q

What are the symptoms of passive congestion

A

Possible elevated LFT’s
Increased hepatic vein pressure

91
Q

What are the sonographic findings of passive congestion

A

Hepatomegaly
Enlarged hepatic veins, IVC, PV, and SV
Ascites

92
Q

What are types of focal diseases

A

Cystic lesions (Simple or congenital)
Polycystic disease
Hematoma
Pyogenic abscess
Hepatic candidiasis
Chronic granulomatous disease
Parasitic infections

93
Q

What are the types of parasitic infections

A

Amebic abscess
Schistosomiasis
Pneumocystic carinii
Echinococcal cyst (Hydatid disease)

94
Q

What are the symptoms of cystic lesions

A

Asymptomatic
Usually incidental findings

95
Q

What are the sonographic findings of cystic lesions

A

Thin walls
Anechoic
Posterior enhancement
Well-defined borders
Calcifications

96
Q

What is a simple cyst

A

Asymptomatic and usually incidental finding

97
Q

What are the 4 characteristics of a simple cyst

A

Well defined borders
Thin walls
Anechoic
Posterior enhancement

98
Q

What are the symptoms of congenital hepatic cyst

A

Asymptomatic
Rare to find a solitary cyst
Incidental findings

99
Q

What are the sonographic findings of a congenital hepatic cyst

A

4 characteristics of a simple cyst
Found in right lobe

100
Q

What are the symptoms of polycystic liver disease

A

Autosomal dominant disease
Associated with polycystic kidney disease
Can be small
Typically simple

101
Q

What is a traumatic cyst

A

Hematoma

102
Q

What is a hematoma

A

Contained collection of blood

103
Q

Where can traumatic cysts/hematomas be found

A

Subcapsular
Intrahepatic

104
Q

T or F:
Sonographic appearance of hematomas do not vary with age

A

False
Do vary with age

105
Q

What is the sonographic appearance of a hematoma within the 1st 24 hours

A

Echogenic

106
Q

What is the sonographic appearance of a hematoma after 24 hours

A

Slowly becomes hypoechoic with lysis of blood
Strandy
Internal echoes

107
Q

What is a liver abscess
Where is the most common place for this

A

Occurs when bacteria destroy hepatic tissue producing a cavity which fills with infectious organisms
Most common in right lobe

108
Q

What is a pyogenic abscess

A

Pus-filled abscess in the liver

109
Q

What are the symptoms of a pyogenic abscess

A

Elevated WBC
Fever
Anemia
Abnormal LFT

110
Q

What are the sonographic findings of a pyogenic abscess

A

Cystic lesion
Variable appearance
Complex-debris or fluid level
Right lobe

111
Q

What is hepatic candidiasis
Who is most at risk

A

Liver affected by hematogenous spread of infection usually from the lungs
Immunocompromised patients

112
Q

What are examples of immunocompromised patients

A

Chemotherapy
Transplant patients
HIV

113
Q

What are the symptoms of hepatic candidiasis

A

Fever
Localized pain
Elevated WBC

114
Q

What are the sonographic findings of hepatic candidiasis

A

Multiple small hypoechoic lesions
Hypoechoic rim with echogenic center
Bull’s eye/Target sign (Wheel within wheel)
FNA of diagnosis

115
Q

What is FNA

A

Fine needle aspiration

116
Q

What is chronic granulomatous disease

A

Disease is genetically hetergenous immunodeficiency disorder

117
Q

What does chronic granulomatous disease result in

A

Inability of phagocytes to kill microbes that they have ingested

118
Q

Who is most at risk for chronic granulomatous disease

A

Patients with CGD are especially at risk to acquire unusual fungal infections

119
Q

What are the symptoms of chronic granulomatous disease

A

Pediatric patients with recurrent UTI’s
Asymptomatic

120
Q

What are the sonographic findings of chronic granulomatous disease

A

Ill defined margins
Hypoechoic
Posterior enhancement
FNA necessary for diagnosis

121
Q

What are parasitic infections

A

Various focal disease caused by parasite

122
Q

What are the symptoms of an amebic abscess

A

Elevated WBC

123
Q

What are the sonographic findings of an amebic abscess

A

Simple round or ova cyst
Hypoechoic with debris

124
Q

What is the most common parasitic infection in humans

A

Schistosomiasis

125
Q

Water/snail born parasite that can penetrate skin, mucosa, lungs, and liver

A

Schistosomiasis

126
Q

What happens when the schistosomiasis enters the liver

A

Destorys the terminal portal veins branches

127
Q

What does schistosomiasis cause
What does it do to the portal tract

A

Causes presinusoidal intrahepatic portal hypertension
Wides (2 cm) and makes echogenic

128
Q

What is associated with the initial hepatomegaly for schistosomiasis

A

Decreased liver size as disease progresses
Periportal fibrosis
Portal hypertension
Varices
Ascites

129
Q

What is pneumocystis carinii

A

Most common organism causing opportunistic infections in HIV patients

130
Q

What is pneumocystis carinii also known as

A

Pneumocystis jiroveci

131
Q

What is the sonographic appearance of pneumocystis carinii

A

Diffuse, tiny, non-shadowing echogenic foci throughout liver
Replacement of normal liver tissue with echogenic clumps of calcification

132
Q

What is echinococcal (Hydatid) cyst

A

Parasitic disease in sheep/cattle raising countries

133
Q

What are the symptoms of echinococcal hydatid cyst

A

Elevated WBC

134
Q

What are the sonographic findings of echinococcal hydatid cyst

A

Simple cyst with possible sand
Have detached endocyst
Densely calcified
Cysts within cysts (Daughter)

135
Q

What are the types of liver masses

A

Benign hepatic tumors
Malignant tumors

136
Q

What are the benign hepatic tumors

A

Hemangioma
Lipoma
Hepatic adenoma
Focal nodular hyperplasia

137
Q

What are the malignant tumors

A

Hepatocellular carcinoma
Metastatic disease
Lymphoma

138
Q

What is a hemangioma

A

Large blood filled cystic spaces

139
Q

What are the symptoms of hemangioma

A

Most common mass
Asymptomatic

140
Q

What are the sonographic findings of hemangioma

A

Hyper to hypoechoic
Enhancement
Mixed pattern from necrosis

141
Q

What is a lipoma

A

Benign tumor primarily composed of fat cells

142
Q

What are the symptoms of a lipoma

A

Asymptomatic

143
Q

What are the sonographic findings of lipomas

A

Hyperechoic mass
Propagation speed artifact

144
Q

What is an adenoma

A

Glandular epithelial mass

145
Q

What are the symptoms of an adenoma

A

Asymptomatic
Possible RUQ pain
Related to OCP’s

146
Q

What are the sonographic findings of an adenoma

A

Hyperechoic with central echoes
Solitary or multiple
Encapsulated, well defined

147
Q

What is a focal nodular hyperplasia

A

Rare, benign liver mass composed of normal liver elements

148
Q

Where are focal nodular hyperplasia thought to arise from

A

Developmental hyperplastic lesions related to congenital vascular formation

149
Q

Who are focal nodular hyperplasia most common in

A

Women under 40

150
Q

What are the symptoms of focal nodular hyperplasia

A

Asymptomatic
Possible RUQ pain
Related to oral contraceptive

151
Q

What are the sonographic findings of focal nodular hyperplasia

A

Found in the right lobe
Multiple
Well define hyper to isoechoic patterns
Look for contour changes or displacement of vessels

152
Q

What are the Doppler findings of FNH

A

Show flow radiating from a central vessel
Vessels appear larger than normal
Arterial signals with high Doppler shifts

153
Q

What is a malignant tumor in the liver

A

Hepatocellular carcinoma

154
Q

What is hepatocellular carcinoma known as

A

Hepatoma
HCC
Primary liver cell cancer

155
Q

What is the most common malignant tumor

A

Hepatocellular carcinoma

156
Q

Who is more at risk and at what ratio

A

Males more at risk than females with 5:1 ratio

157
Q

What are the predisposing factors of HCC

A

Chronic Hep B & C
Cirrhosis
Aflatoxins

158
Q

What are aflatoxins

A

Carcinogen produced by fungi that are prevalent in developing countries

159
Q

What are the symptoms of HCC

A

Asymptomatic until advanced stage
RUQ pain
Weight loss
Ascites
Fatigue
Malaise
Abnormal LFT’s
Elevated AFP
High mortaility rate

160
Q

What is the sonographic apperance of HCC

A

Variable
Solitary, multiple, or diffuse infiltration
Venous invasion
HCC has arterial and venous flow

161
Q

What is the sonographic apperance of smaller HCC masses to larger HCC masses

A

S - <5 cm, hypoechoic become isoechoic
L - Heterogenous, hyperechoic ducts to areas of hemorrhage and necrosis

162
Q

What are the roles of ultrasound in HCC

A

Localize, measure, characterize mass
Eval abdomen and pelvis for adenopathy or ascites
Guidance for biopsy, percutaneous alcohol injection, or cryogenic therapy

163
Q

What is metastasis

A

Most common neoplasm of the liver

164
Q

What are the primary sites of metastasis

A

Colon
Breast
Lung

165
Q

What are the symptoms of metastasis

A

Elevated LFT’s
Jaundice
Pain
Weight loss

166
Q

What are the sonographic findings of metastasis

A

Hypoechoic or echogenic
Bull’s eye
Solitary or multiple
Well to ill defined

167
Q

What is a lymphoma

A

Malignant neoplasms involving lymphocyte proliferation in lymph nodes

168
Q

What are the types of lymphoma

A

Hodgkin’s or non-Hodgkin’s

169
Q

How do you differentiate Hodgkin’s and non-Hodgkin’s

A

Lymph node biopsy

170
Q

T or F
The cause of a lymphoma is unknown

A

True

171
Q

What are the symptoms of lymphoma

A

Hepatomegaly
Elevated LFT’s
Lymphadenopathy

172
Q

What are the sonographic findings of lymphoma

A

Other nodes may be seen
Multiple small discrete masses
Hypoechoic, solid, no enhancement

173
Q

What is portal hypertension

A

Build up of portal vein pressure due to progressive hepatic fibrosis

174
Q

Portal hypertension is increased pressure in the

A

Portal venous system

175
Q

90% of portal hypertension is caused by

A

Cirrhosis

176
Q

In portal hypertension as fibrosis increases, hepatic resistance ____
Portal flow must ___ or portal pressure must increase

A

Increases
Decrease

177
Q

The ligamentum teres is a remnant of what obliterated vein

A

Umbilical vein

178
Q

The ligamentum venosum is a remnant of what obliterated vein

A

Ductus venosus

179
Q

What is the purpose of the ductus venosus

A

Until birth it shunts blood from the umbilical vein to IVC

180
Q

Describe the fetal blood flow

A

Umbilical vein –> Ductus venosus –> IVC

181
Q

What are the sonographic findings in portal hypertension

A

Splenomegaly
Dilated portal veins (MPV > 13mm)
Ascites
Portosystemic venous collaterals

182
Q

What are the Doppler findings in portal hypertension

A

Portal vein becomes monophasic
As PHTN increases blood flow reverses direction

183
Q

Hepatofungal is the flow ___ the liver

A

Out of

184
Q

Hepatopedal is the flow __ the liver

A

In the

185
Q

Portosystemic collaterals form due to
Known as the
If these form the PV diameter will

A

Increased venous pressure
“Path of least resistance”
Decrease

186
Q

This might be placed surgically or percutaneously placed to relieve portal hypertension and pressure on varices

A

Portosystemic shunt

187
Q

What are the different portosystemic shunts

A

TIPS
Mesocaval
Splenorenal

188
Q

What is the splenorenal shunt known as

A

Warren shunt

189
Q

What is a TIPS

A

Trans jugular intrahepatic portosystemic shunt

190
Q

TIPS are regularly evaluated with

A

Ultrasound for patency

191
Q

Where is the TIPS placed

A

Via jugular vein and IVC between the RHV and MPV

192
Q

What is the normal imaging criteria for TIPS

A

Baseline velocities should be 125-200 cm/sec
Turbulent flow
Hepatofungal flow in RPV and LPV

193
Q

What is the abnormal imaging criteria for TIPS

A

Drop in velocity of 50 cm/sec
Overall velocity of 60 cm/sec
No flow
Hepatopedal flow in RPV/LPV
Varices
Ascites

194
Q

Where are portosystemic collaterals seen

A

Gastoesophageal junction
Umbilical vein

195
Q

Where is the portosystemic collaterals in the gastroesophageal junction
And what will be seen as dilated

A

Coronary and gastric veins
Dilated veins around GE junction

196
Q

The umbilical vein connects to the

A

LPV to the superficial veins near umbilicus

197
Q

Rare disorder characterized by occlusion of hepatic veins may involve IVC

A

Budd-Chiari Syndrome

198
Q

What are the causes of Budd-Chiari

A

Congenital
Coagulation abnormalities
Pregnancy
Oral contraceptive use
Tumor extension
Trauma

199
Q

What is the sonographic appearance of Budd-Chiari

A

Hepatomegaly and ascites
Partial or complete inability to visualize hepatic veins
Visible stenosis or thrombus in lumen
Hemorrhagic infractions appear hypoechoic
Enlarged caudate lobe
Abnormal blood flow detected in HV

200
Q

When the hemorrhagic infractions in BCS ages what happened

A

Increases echogenicity due to increased pressure on vessel walls

201
Q

What could be associated with abnormal blood flow in HV

A

No flow
Continuous flow
Reversed blood flow

Abdomen (10 decks)

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