Download MBBS Pathology PPT 12 Obstructive Jaundice Pathophysiology Lecture Notes

Download MBBS (Bachelor of Medicine, Bachelor of Surgery) Pathology PPT 12 Obstructive Jaundice Pathophysiology Lecture Notes

Pathophysiology: Obstructive

jaundice

MRP2/ABCC2

INTRA-HEPATIC

EXTRA-HEPATIC


INFECTIONS

HEPATOCYTES

INFLAMMATION:

? Viral hepatitis

Autoimmune

? Alcoholic hepatitis

DRUG INDUCED

? Drug induced

? Sepsis

Centrilobular

CONGENITAL/INHERITED

? Progressive familial

INTRAHEPATIC

BILE DUCTS

? Primary Biliary

intrahepatic

causes

Periportal

cirrhosis

cholestasis

? Primary sclerosing

? Benign recurrent

cholangitis

cholestasis

? Vanishing bile duct

syndrome

INFILTRATION

? Amyloidosis

? Tuberculosis

? Lymphoma




INSIDE THE LUMEN

IN THE WALL

PRESSURE FROM OUTSIDE

NORMAL HISTOLOGY




GENERAL CHOLESTASIS FEATURES

FEATHERY DEGENERATION

Robbins Pathological Basis of Disease, 9th edition

GENERAL CHOLESTASIS FEATURES

Robbins Pathological Basis of Disease, 9th edition


AUTOIMMUNE

CHOLANGIOPATHIES

Robbins Pathological Basis of Disease, 9th edition

PRIMARY BILIARY CIRRHOSIS

? SMALL & MEDIUM SIZE DUCTS
? NON-SUPPURATIVE
? EXTRA HEPATIC BILIARY TREE NOT

INVOLVED

? PATCHY INVOLVEMENT

" FLORID DUCT LESION"

Robbins Pathological Basis of Disease, 9th edition




PRIMARY SCLEROSING CHOLANGITIS

? BOTH INTRA & EXTRA HEPATIC DUCTS
? INFLAMMTION & SCLEROSIS
? INTERMITTENT SEGMENTS DILATED
? ULCERATIVE COLITIS

"ONION SKIN" FIBROSIS

NORMAL

MR CHOLANGIOGRAM: "BEADING"

Robbins Pathological Basis of Disease, 9th edition

BILE DUCT SCAR FORMATION

"ONION SKIN" FIBROSIS


SPOT THE DIFFERENCES

BILIARY CIRRHOSIS


SPECIAL CASE IN NEONATES

NEONATAL

EXTRA HEPATIC

HEPATITIS

BILIARY ATRESIA

NOT A SINGLE DISEASE

OBSTRUCTIVE CAUSE

NOT NECESSARILY INFLAMMATORY

INFLAMMATION & FIBROSIS

TOXIC, METABOLIC, INFECTIOUS,

IDIOPATHIC

SURGICAL TREATMENT: KASAI

NON- OBSTRUCTIVE

VERY IMPORTANT TO DIFFERENTIATE THE

TWO!

NEONATAL HEPATITIS

EHBA

EHBA

Robbins Pathological Basis of Disease, 9th edition


AMYLOIDOSIS

Summary

? Causes

? Intra: Hepatocytes, Bile ducts, Portal tract

? Extra: Benign, Malignant

? NEONATES

? Neonatal Hepatitis

? EHBA

? Early phases: Reversible

? Late stages: Biliary cirrhosis Irreversible