Diseases of the liver and biliary tract

Acute cholecystitis

Acute cholecystitis is an acute inflammation of the gallbladder wall. In the vast majority of cases, acute cholecystitis develops when the cystic duct is obstructed by a stone, which provokes an increase in intravesical pressure. Thus, acute cholecystitis is the most common complication of cholelithiasis.

Portal hypertension - Symptoms

Liver cirrhosis is the most common cause of portal hypertension. In patients with liver cirrhosis, it is necessary to find out all possible causes, including a history of alcoholism or hepatitis.

Portal hypertension

Portal hypertension is an increase in pressure in the portal vein basin caused by a disturbance in blood flow of various origins and locations - in the portal vessels, hepatic veins and inferior vena cava.

Cholestasis - Treatment

Indications for surgical or conservative treatment are determined by the cause of obstruction and the patient's condition. In case of choledocholithiasis, endoscopic papillosphincterotomy and stone removal are used. In case of biliary obstruction by a malignant tumor in operable patients, its resectability is assessed.

Cholestasis - Diagnosis

The bilirubin content in the blood increases progressively, usually during the first 3 weeks of cholestasis, mainly due to the conjugated fraction. As the severity of cholestasis decreases, the bilirubin level in the blood begins to decrease quite slowly due to the fact that during the existence of cholestasis, bilialbumin (bilirubin bound to albumin) is formed in the blood.

Cholestasis - Symptoms

The leading symptoms of cholestasis (both acute and chronic) are skin itching and malabsorption. Chronic cholestasis is characterized by bone damage (hepatic osteodystrophy), cholesterol deposits (xanthomas, xanthelasmas) and skin pigmentation due to accumulation of melanin.

Cholestasis - Pathogenesis

Changes in bile flow are observed in duct damage caused by inflammation and destruction of the epithelium, but these changes are secondary rather than primary. The role of disturbances in the transmembrane conductivity regulator of epithelial cells of the ducts in cystic fibrosis requires further study.

Cholestasis - Causes

Extrahepatic cholestasis develops with mechanical obstruction of the main extrahepatic or main intrahepatic ducts.

Cholestasis - Classification

Cholestasis is divided into extra- and intrahepatic, as well as acute and chronic. Extrahepatic cholestasis develops with mechanical obstruction of the bile ducts, usually outside the liver; at the same time, obstruction in cholangiocarcinoma of the liver porta, growing into the main intrahepatic ducts, can also be attributed to this group.

Bile formation

The construction of microfilaments involves interacting polymerized (F) and free (G) actins. Microfilaments, concentrated around the canalicular membrane, determine the contractility and motility of the canals. Phalloidin, which enhances actin polymerization, and cytochalasin B, which weakens it, inhibit canal motility and cause cholestasis.