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Vascular liver diseases
1Division of Gastrointestinal and Liver Diseases, University of Southern California Keck School of Medicine, 2011 Zonal Avenue-HMR 603, Los Angeles, CA 90033, USA. deleve@hsc.usc.edu
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This review covers primary circulatory liver diseases like Budd-Chiari syndrome and portal vein thrombosis. These conditions often cause portal hypertension before liver dysfunction, unlike parenchymal liver diseases.
Area of Science:
- Hepatology
- Vascular Medicine
- Internal Medicine
Background:
- Primary circulatory liver diseases affect hepatic blood flow.
- Conditions include Budd-Chiari syndrome, portal vein thrombosis, and sinusoidal obstruction syndrome.
- Systemic diseases like ischemic hepatitis also impact liver circulation.
Purpose of the Study:
- To review primary circulatory liver diseases.
- To differentiate their presentation from parenchymal liver diseases.
- To highlight shared risk factors and varying pathogenesis.
Main Methods:
- Literature review of primary circulatory liver diseases.
- Comparative analysis with primary parenchymal liver diseases.
- Discussion of associated cardiovascular conditions.
Main Results:
- Circulatory liver diseases typically manifest portal hypertension before liver dysfunction.
- Parenchymal liver diseases show liver dysfunction preceding portal hypertension.
- Significant overlap in risk factors exists among these hepatic circulatory disorders.
Conclusions:
- Understanding the distinct progression of circulatory versus parenchymal liver diseases is crucial.
- Recognizing shared risk factors aids in diagnosing and managing these complex conditions.
- Further research into the varied pathogenesis of individual circulatory liver diseases is warranted.
Abstract:
This article reviews the primary circulatory liver diseases, which include Budd-Chiari syndrome, obstruction of the hepatic portion of the inferior vena cava, portal vein thrombosis, sinusoidal obstruction syndrome (veno-occlusive disease), nodular regenerative hyperplasia, and peliosis hepatis. In addition, two systemic cardiovascular diseases that impair hepatic circulation, ischemic hepatitis and congestive hepatopathy, are briefly discussed. A characteristic of the primary circulatory liver diseases is that portal hypertension usually precedes liver dysfunction; however, this is not the case with the primary parenchymal liver diseases, in which liver dysfunction always progresses before portal hypertension is manifested. Significant overlap exists among the diseases and risk factors that predispose patients to the primary circulatory liver diseases, though the pathogenesis of individual diseases varies.