Hepatic Alterations in Obstructive Jaundice

A clinical and histochemical study of cholestasis

“…The precise mechanism by which these intercellular thrombi are formed, preferentially in centrolobular location, is not yet clear. The increasing accumulation of bilirubin (and surely other bile constituents as well) in and outside the liver cells has a damaging effect, histologically described as 'feathery degeneration' (Popper and Schaffner, 1967;Gall and Dobrogorsky, 1964). This parenchymal damage triggers a proliferative and hyperplastic reaction of the Kupffer cells, which become macrophages.…”

Liver histopathology in chronic common bile duct stenosis due to chronic alcoholic pancreatitis

“…In such conditions, however, its diagnostic significance seems to be less important. Gall and Dobrogorski (8) did not find a significant difference either in intensity or in frequency of portal edema in patients with obstructive jaundice and patients with acute hepatitis; we feel that increased portal connective tissue and prominent lymphocytic and/or granulocytic reaction, features frequently encountered in complete d u c t obstruction, may obscure the intensity of the edema.…”

“…Although portal edema has been identified as an early feature of EHO from previous studies (8,16), it's ability to erode the periportal region and create a peculiar portal morphology (Figure la) leading occasionally to pseudolobulation has not been adequately emphasized. We believe that extensive portal edema associated with relatively mild lymphoid cell reaction and significant ductular and pseudoductular proliferation of the periphery of the edematous tissue, represents relatively early or acute intrahepatic pathologic process, which reflects the recent onset of an obstructive process.…”

“…Furthermore, patients with CBD stenosis due to chronic pancreatitis provide an ideal model for study of early and advanced histologic sequelae in the liver of an incomplete "lowgrade" obstruction of the biliary tree with mild or absent jaundice. Previous reports (6)(7)(8)(9) dealing with biliary obstructive liver disease have focused on complete or "highgrade" obstruction of the biliary tree with an overt clinical and biochemical cholestatic syndrome. Furthermore, the insidious onset and frequent subclinical character of the cholestatic syndrome in alcoholics with chronic pancreatitis and the possible coexistence of histologic features of two diseases [i.e., alcoholic liver disease (ALD) and extrahepatic biliary obstructive changes], presents a unique situation which may confuse the clinician and pathologist.…”

Diagnosis of Obstructive Jaundice

“…Her liver was en¬ larged and nodular, but the liver scan did not suggest metastasis. Laboratory studies disclosed the following values: increase in bilirubin, 7 (Fig 2). She was found to have carcinoma of the pancreas when laparoto¬ my was performed.…”