[Cirrhosis of vascular origin]
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Published on: August 1, 2018
1Service d'hépatogastroentérologie, groupe hospitalier Pitié-Salpétrière, Paris.
Insights
Vascular cirrhosis arises from blockages in veins draining the liver, not the portal vein or hepatic artery. Differentiating it from other liver diseases is crucial.
Area of Science:
- Hepatology
- Vascular Medicine
- Pathology
Context:
- Cirrhosis of vascular origin is specifically linked to obstructions within the hepatic venous outflow tract.
- Obstructions in the portal vein or hepatic artery do not precipitate this type of cirrhosis.
- Distinguishing vascular cirrhosis from other intrahepatic small vessel diseases is essential.
Purpose:
- To define the specific vascular origins of cirrhosis.
- To differentiate vascular cirrhosis from conditions with similar presentations.
- To clarify the etiological factors contributing to vascular cirrhosis.
Summary:
- Cirrhosis of vascular origin results from obstructions in the vessels draining the liver, including small hepatic veins, large hepatic veins, or the inferior vena cava.
- Conditions affecting small intrahepatic vessels can mimic cirrhosis but require distinct diagnosis.
- Chronic cardiac liver may resemble vascular cirrhosis, though true cardiac cirrhosis is considered exceptional.
Impact:
- Provides a clear etiological definition for vascular cirrhosis.
- Aids in the differential diagnosis of liver diseases.
- Clarifies the limited role of cardiac disease in causing cirrhosis.
Abstract:
Cirrhosis of vascular origin is seen only in case of obstacle on the vessels that drain the liver, i.e. the small hepatic veins, the large hepatic veins or the segment of the vena cava comprised between its junction with the hepatic veins and the right atrium. Obstruction of the portal vein or the hepatic artery proper does not cause cirrhosis. Some diseases of the small intrahepatic vessels may mimic cirrhosis but must be distinguished from it. Chronic cardiac liver may also resemble vascular cirrhosis, but "cardiac cirrhosis", if it exists, is probably exceptional.
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